Sudden onset generalised yellowish papules

A woman in her 20s presented to the dermatology clinic with a seven day history of sudden onset, itchy, painless, yellowish papules on the trunk and extremities. This was her first presentation and she had no medical conditions or allergies. She reported infrequent alcohol consumption and did not use steroids or oestrogen-containing medications. She had a body mass index of 26, and her family history was unremarkable.

On physical examination, numerous yellowish firm papules were visible over her trunk and extremities, accentuated on the extensor surfaces (fig 1). Laboratory tests showed a total cholesterol level of 42.66 mmol/L (reference range 3.14-5.86), a triglyceride level of 77.77 mmol/L (0.30-1.70), a low density lipoprotein level of 8.37 …