Diabetes mellitus (DM) can be complicated by a variety of cutaneous manifestations. Various xanthoma can appear, according to different subtypes of hyperlipopoteinemia, which is caused by only primary causes, like familial hyperlipoproteinemia, but also secondary causes that is DM, thyroid gland disorder, and diet. Dermatologic findings may even precede any clinical or biological evidence of DM. Thus, cognition of specific dermatologic findings, like xanthoma, can help identify DM, especially in children. We report a case of type IV hyperlipoproteinemia and eruptive xanthoma, associated with DM in a 12-year-old female. She was diagnosed of type IV hyperlipoproteinemia, through a lipid profile, electrophoresis and eruptive xanthoma from a skin biopsy. Although she showed overweight in BMI and had a mother with Type 2 DM, she was too little to have DM, and showed normal urine test. We examined thyroid function test and fasting blood sugar to rule out secondary hyperlipoproteinemia. Fasting blood sugar was increased enough to diagnose her with DM