REPORT OF A CASE
The patient, a 62-year-old white woman, was referred to the University of South Florida Medical Clinics, Tampa, for examination of pruritic lesions of her extremities that were present intermittently for a few years. The physical examination disclosed periorbital edema; dry skin over both lower extremities; and a few eczematous, coin-shaped lesions on the extensor aspects of the lower extremities. On careful inspection of the skin, the patient was noted to have waxy, indurated pale areas over the right pretibial region and two large, exuberant tumoral lesions with brawny edema on the dorsum of her left foot (Fig 1). Examination of her nails revealed clubbing (Fig 2). Biopsy specimens were obtained and sent for hematoxylin-eosin (Fig 3) and special staining (Fig 4).What is your diagnosis?
Localized myxedema is an infiltrative, metabolic dermopathy with deposition of acid mucopolysaccha-rides in the dermis.1-5 Classically, this process manifests cutaneously as raised, waxy nodules or plaques varying in color from flesh to yellow-brown to red.
Albers SE, Fenske NA. Exuberant Tumoral Lesions on the Dorsum of the Foot. Arch Dermatol. 1991;127(2):249-250. doi:10.1001/archderm.1991.01680020117018