A 30-year-old male patient came to Medicine OPD for swellings which looks like grapes, he said initially it was small cluster of swelling which later increased in size. He also complained of yellowish pigmentation of creases of palms. His fasting lipid profile was done, both cholesterol and triacylglycerols level was elevated. What is the diagnosis?

**Core Concept**
Xanthomas are a group of skin lesions that result from the accumulation of lipids in the skin, often associated with dyslipidemia. In this case, the patient's symptoms and laboratory findings suggest a specific type of xanthoma related to elevated levels of triglycerides.

**Why the Correct Answer is Right**
The patient's presentation of multiple small, yellowish papules that coalesced to form larger clusters, along with elevated triglyceride levels, is characteristic of eruptive xanthoma. Eruptive xanthomas are a type of xanthoma that occurs in response to high levels of triglycerides, often seen in conditions like hypertriglyceridemia or type 4 hyperlipoproteinemia. The yellowish pigmentation of the creases of the palms is also a key feature of eruptive xanthoma.

**Why Each Wrong Option is Incorrect**
**Option A:** Tuberous xanthoma is a type of xanthoma associated with elevated levels of LDL cholesterol, not triglycerides. It typically presents as a solitary, firm, yellowish papule, not a cluster of lesions.
**Option B:** Xanthelasma is a type of xanthoma that occurs on the eyelids, often in association with hyperlipidemia. It does not typically present as a cluster of lesions on the skin.
**Option C:** Eruptive xanthoma is a specific type of xanthoma that occurs in response to high levels of triglycerides, making this the correct answer.

**Clinical Pearl / High-Yield Fact**
Eruptive xanthoma is a key diagnostic clue for conditions like hypertriglyceridemia or type 4 hyperlipoproteinemia, which can increase the risk of pancreatitis and other cardiovascular events.

**Correct Answer:** C. Eruptive xanthoma.

✓ Correct Answer: D. Familial dysbetalipoproteinemia