Yellow plaques on the hands of a 10-year-old girl

A 10-year-old Lebanese girl presented with intertriginous yellow plaques on both hands (Fig 1). The lesions were asymptomatic. On further history and examination, she had a significant family history of dyslipidemia, similar skin lesions on both knees and elbows, and a carotid bruit. A fasting lipid profile showed total cholesterol of 800 mg/dL, low-density lipoprotein of 544 mg/dL, high-density lipoprotein of 128 mg/dL, and triglycerides of 312 mg/dL. A carotid duplex ultrasonography scan revealed 50% carotid stenosis on the right side, and a 2-dimensional echocardiogram revealed mild mitral regurgitation.

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