A man in his 40s presented with a 3-week history of asymptomatic yellowish nodules on his palms, soles, and elbows. The patient adopted a carnivore diet approximately 8 months before presentation. His dietary habits included a high intake of fats, consisting of 6 to 9 lb of cheese, sticks of butter, and additional fat incorporated into his daily hamburgers. He reported weight loss, increased energy, and improved mental clarity. Physical examination revealed multiple painless yellowish nodules on his palms (Figure) and elbows. The patient's cholesterol level exceeded 1000 mg/dL (to convert to millimoles per liter, multiply by 0.0259), significantly higher than his baseline of level of 210 to 300 mg/dL. A diagnosis of xanthelasma was made. This case highlights the impact of dietary patterns on lipid levels and the importance of managing hypercholesterolemia to prevent complications.1-3