RT Book, Section A1 Usatine, Richard P. A1 Smith, Mindy A. A1 Chumley, Heidi S. A1 Mayeaux, E.J. SR Print(0) ID 57685343 T1 Chapter 223. Hyperlipidemia and Xanthomas T2 The Color Atlas of Family Medicine, 2e YR 2013 FD 2013 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-176964-8 LK accessmedicine.mhmedical.com/content.aspx?aid=57685343 RD 2024/03/28 AB A 27-year-old Hispanic man reported new painful nonpruritic bumps, which started 6 months ago, over his entire body. The patient had not seen a physician for 10 months and had run out of his oral medicines for type 2 diabetes mellitus. His grandmother had a milder version of bumps like this years ago. The firm yellowish papules were present all over his body from the neck down (Figures 223-1, 223-2, and 223-3). Laboratory evaluation revealed a random blood sugar of 203, a fasting triglyceride level greater than 7000 mg/dL, and total cholesterol greater than 700 mg/dL. High-density lipoproteins were 32 mg/dL, and there were no chylomicrons present. The patient was diagnosed with xanthomas, poorly controlled diabetes mellitus, and hyperlipidemia, and was started on metformin, gemfibrozil, and a β-hydroxy-β-methylglutaryl-coenzyme A (HMG-CoA)-reductase inhibitor.