ABSTRACT
Xanthoma may or may not be associated with abnormal serum lipids. Normolipidemic xanthomas can occur in association with underlying lymphoproliferative disease, or they can result from lipid deposition with damaged or altered skin. A 56-year-old woman presented with multiple, yellowish to erythematous papules and plaques on the periocular area and forehead. She had no evidence or history of hyperlipidemia. The biopsy specimen of the forehead showed a diffuse histiocytic infiltrate with abundant bubbly cytoplasm, associated with lobular lymphocytic panniculitis and mucin deposition. Based on the clinical and histopathologic findings, we diagnosed this case as lupus erythematosus panniculitis with xanthomatous reaction. The patient was treated with low dose oral steroids and antimalarials, and her skin lesions were improved after 2 weeks.