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Tuberous xanthomas are nontender, yellow to red papules to nodules that occur on the extensor surface, and trauma-prone areas such as the elbows, knees, Achilles tendon, and buttocks. A 10-year-old female child born out of second-degree consanguineous marriage presented with multiple skin-colored nodular lesions on axillary folds, both elbows, cubital fossa, medial side of the wrist, interphalangeal joints, buttocks, knees, popliteal fossa, and Achilles tendons. After complete evaluation, diagnosis of familial hypercholesterolemia type IIa with tuberous xanthoma was made. Tuberous xanthoma usually presents in combined type III dyslipidemias, but in our case, it is presented in type IIa familial hypercholesterolemia. Early diagnosis and treatment of familial hypercholesterolemia are important for preventing complications.

Porokeratosis is an autosomal dominant disorder of epidermal keratinization resulting from abnormal expansion of latent clones following chronic ultraviolet exposure or immunosuppression. Various clinical and morphological variants of porokeratosis are present, among which disseminated superficial actinic porokeratosis (DSAP) is the most common subtype located predominantly on the sun exposed areas, whereas disseminated superficial porokeratosis (DSP) is present both on the sun exposed and sun protected areas including oral mucosa and genitalia. Porokeratosis is characterized clinically by annular plaques with atrophic center and thready border and histologically by the presence of cornoid lamella. DSAP may be missed because of its inconspicuous nature in dark skinned individuals and may sometimes be mistaken for actinic keratoses in sun-damaged skin. Here, we report a case series of five patients with disseminated porokeratosis with varied presentations.