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Localized Myxedema: "Burned-Out" Hyperthyroidism; Hypertension. Presented by Dr. Carmen C. Thomas.
H. D., a Negro woman aged 70, presents an almost complete alopecia of the scalp and marked enlargement of the feet, ankles, and toes by a soft verrucous hyperplasia. The skin resembles elephant hide. On the left leg, there is a palm-sized, smooth, slightly elevated plaque. Marked exophthalmos is present.
The patient has had several admissions to hospital with episodes diagnosed as hypertensive encephalopathy. In 1948, she was treated for thyrotoxicosis with propylthiouracil. Her blood pressure ranges up to 300/140. The cutaneous changes in the skin of the legs began approximately in May, 1949, and have slowly progressed.
The blood pressure at the time of presentation is 220/96.
Radioactive iodine uptake was 43% on Dec. 3, 1950. Roentgenograms of the skull showed no abnormalities. The blood sugar range was 114 to 256 mg. per 100 cc. in 1950-1951.
Twining HE, Shaffer B. PHILADELPHIA DERMATOLOGICAL SOCIETY. AMA Arch Derm Syphilol. 1953;67(1):112–114. doi:10.1001/archderm.1953.01540010116023
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