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The concepts of cutaneous xanthomas of various types have been broadened and greatly changed in the last two decades. Many separate and interrelated factors, such as the relative amounts of the various lipoids in the blood,1the role played by the liver2and the pituitary gland,3by vitamins A and D and by diets4and descriptions of some unusual forms of xanthoma, like lipoid proteinosis (lipoidosis cutis et mucosae5), in which there apparently is primarily a disturbance of the phosphatide metabolism, have made the problem more complex. Cases of the Hand-Schuller-Christian syndrome and of Niemann-Pick's disease in which there were cutaneous xanthomatous lesions have been reported.6Hepatosplenomegaly7(lipoidosis of the skin and the mucous membranes), as described by Burger and Grutz, and Gaucher's disease belong in the category of systemic xanthomatoses.8 Space does not permit us to discuss the various classifications
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Hugh Montgomery (1938) studied this question.
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