Do you know this syndrome?
A 17-year-old female patient was referred from the Endocrinology Department with\nyellowish papules on her arms and legs for about a year.\nOn examination, the patient presented acromegaloid fascies, generalized lipoatrophy,\nphlebomegaly, hepatomegaly, axillary acanthosis nigricans, clitoromegaly, and yellowish\ncoalescing and isolated papules with an erythematous halo in the upper and lower limbs\n().\nFrom birth, she presented a total absence of subcutaneous fat. At age 10, she had\nimpaired glucose tolerance which, because unchecked, had developed into diabetic\nketoacidosis in under one year. Subsequently, she presented type 2 diabetes mellitus\n(DM) associated with dyslipidemia and hepatic steatosis. These disorders were not\nresponsive to the usual pharmacological doses, and required the administration of high\ndoses of exogenous insulin, oral hypoglycemic and hypolipidemic agents. Despite therapy,\ntests showed fasting glucose level of 284 mg/dl; postprandial glucose, 423 mg/dl; total\ncholesterol, 579 mg/dl; and triglycerides, 3.194 mg/dl. Histopathological examination\nconfirmed clinical hypothesis of eruptive xanthoma ().