Background: Type III hyperlipoproteinaemia (HLP) is a rare form of dyslipidaemia characterized by skin lesions such as palmar crease xanthoma and tuberous xanthomas. To our knowledge, there have been no previous reports of yellow-orange discoloration of the skin and xanthomas associated with this disease.
Case report: A 61-year-old woman consulted for palmar crease xanthoma and tuberous xanthomas of the elbows with odd yellow-orange discoloration. Laboratory investigations demonstrated type-III HLP and a high serum lycopene level. After 14 weeks of lipid-lowering treatment, the xanthomas and discoloration showed improvement. In addition, lipid levels and serum lycopene had returned to normal.
Discussion: All cases of lycopenaemia reported in the literature followed excessive ingestion of lycopene in foods. We describe the first case of lycopenaemia with orange discoloration of xanthomas following raised serum lycopene but not involving excessive dietary intake. Type-III HLP was doubtless instrumental in the physiopathogenesis of these orange lesions.