Ureaplasma spp is a type of bacteria under the bacteria family of mycoplasma species. There […]
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Recently a patient walked into the clinic with a concern of acne on the shoulder that has remained unresolved over the course of several months.
What comes to mind?
He has a previous diagnosis of hypertriglyceridemia– elevated triglyceride levels in the flood. The rash that this patient mistook as acne is, in fact, eruptive xanthomas. Not all rashes are merely a skin condition. Rashes may be more than skin deep and suggestive of an underlying medical condition that has yet to be addressed.
The objective of this article is to promote awareness on the possibility of a warning sign of systemic cardiovascular health issues. This is when a person is plagued with a seemingly benign dermatological rash.
Eruptive xanthomas are small (less than 1cm) yellow-hued papules with a reddish rim that can be seen over the shoulders, upper back, neck, abdomen, face, knees, and the buttock region. They can be slightly tender and/or itchy.
While uncommon, eruptive xanthoma can be noticeable if a person has it. Eruptive xanthomas can be seen in 8.5% of patients with severe hypertriglyceridaemia. The lesions are benign and can resolve over time with treatment and management of the triglyceride level.
As mentioned, it is associated with severe hypertriglyceridaemia which is a condition where a person’s blood has abnormally elevated or high concentrations of triglycerides (a type of fat). If this is left unattended, you can be at risk of cardiovascular complications such as a stroke, coronary heart disease, heart attack, or even pancreatitis.
If you have an unexplained rash that is yellowish with a red rim and you are concerned that it could be a sign of eruptive xanthomas, do see a doctor to get yourself checked.
Triglycerides are lipids (fats) that can be found in your bloodstream. Triglycerides are made up of fatty acids (both saturated and unsaturated) and glycerol (a form of sugar).
They are produced from extra carbohydrate, alcohol, and glucose that we consume and are stored in the fat cells of our body. Our liver also naturally produces triglycerides. Triglycerides are used as a source of energy when required or when you are in between your meals.
Triglycerides are stored unused fat cells or calories. These provide your body with energy when required. Cholesterols, on the other hand, are proteins that help to synthesise cells and hormones.
Hypertriglyceridaemia is a common medical condition that is often encountered when a person performs a blood test for lipid screening as part of a cardiovascular risk workup. It is defined as an abnormal concentration of triglycerides in the blood. A normal triglyceride level is less than 150 mg/dl.
According to the Ministry of Health (MOH), Singapore, Clinical Practice Guidelines for lipid, the definition of hypertriglyceridaemia is as below:
There are several factors that may increase your risk of developing hypertriglyceridaemia, these are:
Patients with elevated triglyceride are usually asymptomatic. However, they may have non-specific symptoms when the triglyceride level is greater than 1000 to 2000 mg/dl.
Clinical symptoms include:
You are advised to seek medical attention if you develop any of the above symptoms to evaluate further any underlying medical conditions.
Hypertriglyceridaemia can be subcategorised into primary and secondary causes:
You are advised to discuss with your doctor with regards to your family history and general lifestyle patterns. Your doctor will be able to identify any modifiable causes of hypertriglyceridaemia and work out a feasible health care plan to improve and monitor your triglyceride level, simply make an appointment with us.
When triglyceride levels are elevated, a person can be at risk of pancreatitis. The risk for pancreatitis is elevated when the triglyceride level is more than 1000 mg/dl.
As elevated triglyceride is often associated with other abnormal lipid readings such as low high-density lipoprotein (HDL), high low-density lipoprotein (LDL) hypertension, diabetes, obesity, and metabolic syndrome, it can hence also be associated with a higher risk of cardiovascular issues such as coronary heart disease and stroke accidents.
If you are in adulthood, you may consider screening your cholesterol (including triglyceride levels) at least once every 2-3 years, as cholesterol levels tend to increase as we age. You are advised to speak to your health care provider, as you may be offered the tests more frequently depending on your previous results and underlying medical risk factors.
Your doctor will obtain a medical and social history to understand your general health status and background lifestyle. Your doctor may also obtain a family history for cardiovascular risk factor assessment. A physical examination covering the cardiovascular system will be offered. Depending on your individual risk factors, your doctor may advise for blood tests to screen for cholesterol profile, diabetes screening, and other vital organs screening.
The aim of treating hypertriglyceridaemia is to prevent and reduce risk of pancreatitis and cardiovascular disease.
Your doctor will advise you on lifestyle modifications, such as:
If lifestyle changes are inadequate to control the triglyceride level, your doctor may prescribe you with oral medications to manage the levels. The risks and benefits of individual pharmacological options will be discussed prior to prescribing. Medication options include omega-3 fatty acids, fibrate, niacin, or statin.
While hypertriglyceridaemia is a medical condition that is generally asymptomatic, our body may signal us with vague symptoms such as rash or gastrointestinal symptoms to warn us of an underlying brewing medical condition. Take care of your cholesterol and triglyceride level with early screening and testing with us!
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