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Pretibial Myxedema. Presented by Dr. Donald Shasky and Dr. Jerald Nelson.
The patient is a 36-year-old Negro housewife. Following cessation of menses, the patient was examined by a South Dakota physician, during February 1958, and found to have a diffuse goiter and possibly some bulging of the eyes (Fig 1). Protein-bound iodine (PBI) at that time was 19 μg/100 cc; subsequently, she was treated with propylthiouracil and a strong iodine (Lugol's) solution. In May 1958 a total thyroidectomy was performed at Loma Linda University Hospital. Pathological examination showed a diffuse hyperplasia with an associated fetal adenoma. The patient began receiving 0.12 gm thyroid daily. One month later "knots" developed on both legs, which rapidly enlarged, and spread downward so that by September 1958, she was unable to wear shoes (Fig 2).
THE METROPOLITAN DERMATOLOGICAL SOCIETY OF LOS ANGELES. Arch Dermatol. 1966;94(5):658–660. doi:10.1001/archderm.1966.01600290132025
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