Several other external manifestations of hyperlipidaemia are more non-specific but should, nonetheless, alert the clinician to the possibility that disorders of lipoprotein metabolism may have occurred. These include the presence of xanthelasma and corneal arcus. Xanthelasma (Fig. 6.23) can occur in familial hypercholesterolaemia, diabetes, and chronic obstructive liver disease, and may even signify more subtle abnormalities of plasma lipoproteins, such as those seen in apo E or hyper-apo B.
