History:

A middle-aged lady presented with yellowish-orange palmar creases involved both hands of many years duration. Her lipid profile showed hypercholesrolemia and she gave positive family history (her father) of early onset ischemic heart disease. Palmar Xanthomas consist of nodules and irregular yellowish plaques involving the palms and flexural surfaces of the fingers. Striated xanthomas appear as yellowish streaks that follow the distribution of creases of the palms and soles. These lesions are seen in familial dysbetalipoproteinemia, multiple myeloma, and biliary cirrhosis.