The lesions illustrated here are typical of xanthoma striatum palmare, a form of planar xanthoma. This patient also has biliary cirrhosis. Note how the yellowish papules and plaques follow the creases of the fingers and the palmar folds. The familial hyperlipidemias, particularly types II, III, and V, may present with an identical clinical picture. Patients with these disorders are at high risk for ischemic heart disease.