Cutaneous Xanthoma- A Clue to Familial Hypercholesterolemia

A thirty-year-old female presented with multiple non-tender symmetrical slow growing swellings over dorsal aspect of bilateral foot, bilateral elbows and over interphalangeal joints for 5 years. The patient had similar swellings over the natal cleft, left knee, and dorsum of the hand which was surgically excised fifteen years ago. Her elder brother and sister also had similar complaints of multiple painless swellings.