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June 1955


AMA Arch Derm. 1955;71(6):772-776. doi:10.1001/archderm.1955.01540300094026

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Pretibial Circumscribed Myxedema. Presented by Dr. Laurence J. Underwood and Dr. Walter S. Green.

Mrs. V. T., a 34-year-old housewife, had a thyroidectomy in 1950 for hyperthyroidism. Preoperatively, the B. M. R. was +55, and following surgery the B. M. R. dropped to —18. Within a year following the surgery she began developing a thickened asymptomatic plaque on each distal shin. These have persisted unchanged to date. She has had dry scaly skin for years, and for the past seven years she has had recurrent eczema of the fingers.

Each distal shin presents a sharply elevated, firm, rubbery or doughy, scaly, slightly erythematous and slightly pigmented plaque about 7 by 11 cm. with characteristic "pig-skin" or "orange-peel" changes. Asteatotic and mildly ichthyotic changes are present in the skin of the extremities and hyperkeratotic plaques are present on the elbows and knees. Mild eczematoid dermatitis is present on the

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