Eruptive xanthomas are a consequence of severe chylomicronemia and hypertriglyceridemia. They are accumulations of lipid-laden macrophages that present abruptly as pruritic, small, yellow-to-orange papules most commonly scattered over the buttocks and extensor surfaces of extremities. Acutely, variable amounts of pruritus or pain may be present. Hypertriglyceridemia may result from hereditary conditions, such as lipoprotein lipase deficiency or familial hyperlipoproteinemia, or from secondary causes, such as excessive alcohol intake (alcohol use disorder), hypothyroidism, nephrotic syndrome, diabetes mellitus, obesity, a sedentary lifestyle, and a carbohydrate-rich diet. Certain medications (eg, systemic retinoids such as isotretinoin and acitretin, estrogens, protease inhibitors, cyclosporine, prednisone) are also common causes of secondary hypertriglyceridemia. Triglyceride levels in patients with eruptive xanthomas often exceed 3000-4000 mg/dL. Hypertriglyceridemia in the range of 1500 mg/dL or greater can also lead to pancreatitis.

The skin lesions usually resolve within 6 months with appropriate treatment.