Unexplained Skin Rash and Severe Hyperlipidemia: Therapeutic Plasmapheresis as an Effective Solution

Clinical Presentation and Examination

A 38-year-old female patient presented with a widespread, progressive skin rash covering a large surface area of the body (xanthelasma-like lesions), which had persisted for a long period and demonstrated progression over time. The rash was not associated with pain. Laboratory tests prescribed by a dermatologist revealed extremely elevated lipid levels: total cholesterol – 28.5 mmol/L, triglycerides – 97.28 mmol/L. The diagnosis of molluscum contagiosum was ruled out.

Diagnosis and Pathophysiology

The patient was diagnosed with hyperlipidemia and severe hypertriglyceridemia. Such conditions may be associated with familial hyperlipidemia, insulin resistance, type 2 diabetes mellitus, metabolic syndrome, or other metabolic disorders. In this case, the skin manifestations were a direct consequence of markedly elevated lipid levels in the blood.

Treatment and Outcome

Therapeutic plasmapheresis was indicated as part of the treatment. Three sessions were performed, along with the administration of lipid-lowering medications. Following treatment, a significant positive outcome was observed: the skin rash almost completely resolved, triglyceride levels decreased to 6.87 mmol/L, and cholesterol levels decreased to 5.57 mmol/L.

Plasmapheresis enabled the removal of excess cholesterol and triglycerides from the blood plasma, resulting in marked improvement in both laboratory parameters and skin condition.