This case-control study, consisting of a medical record review (from 2002 to 2010), was conducted at Rhode Island Hospital in Providence and South Shore Medical Center, Atrius Healthcare System, in Norwell, Massachusetts. Inclusion criteria were age older than 18 years, histopathologic confirmation of diagnosis, and adequate clinical data on the skin disease, comorbidities, lipid levels, and medications. Data on age, sex, race/ethnicity, socioeconomic status, age at onset of GA, location and clinical features of skin lesions, histopathologic diagnosis, lipid values, comorbidities (type 2 diabetes mellitus, hypertension, hypothyroidism, obesity, and metabolic syndrome), smoking status, and use of lipid-lowering medications and/or β-blockers were collected. Socioeconomic status was approximated by medical insurance status (scale of 1-3, with 1 being the lowest and 3 the highest). Lesions were characterized as localized, disseminated (>10 lesions), or generalized (involving the trunk and upper or lower extremities), as previously defined.23 Annular GA lesions were composed of individual coalescing papules arranged in a ringlike or circinate configuration.3 In accordance with previous studies,3 cases with predominantly annular GA lesions were classified in the annular subgroup. A thorough search revealed 140 cases with complete historic and clinical/laboratory data that were selected from a pool of 400 patients; 420 individuals serving as controls, with a ratio to cases of 3:1, were selected from a pool of 4000. Controls were selected from primary care clinics at Rhode Island Hospital and South Shore Medical Center and were confirmed to not have a history of GA and skin diseases associated with hyperlipidemia, such as necrobiosis lipoidica. The records of patients serving as controls were matched to cases on the following variables: age, sex, race/ethnicity, type 2 diabetes mellitus, hypothyroidism, and hypertension. Furthermore, controls closely approximated cases in demographics and socioeconomic status. The study was approved by the Lifespan institutional review board, the major teaching hospitals affiliated with the Warren Alpert Medical School of Brown University.