fig1

Figure 1. Physical signs of hypercholesterolemia. Top left: Xanthelasma, a planar cutaneous xanthoma located near the orbit, is less specific for FH than arcus cornealis, which appears superiorly and inferiorly at the limbus. Top right: Subcutaneous xanthoma at the ankle and thickened Achilles tendon in a teenager with HoFH. Bottom left: The hands of a child with HoFH showing pathognomonic interdigital web planar xanthomas and cutaneous tuberous xanthomas. Bottom right: Lipid deposits in the creases of the palm and fingers, indicative of dysbetalipoproteinemia.