RT Book, Section A1 Clark, Shane A1 Dean, Steven M. A2 Dean, Steven M. A2 Satiani, Bhagwan A2 Abraham, William T. SR Print(0) ID 1105291976 T1 PRETIBIAL MYXEDEMA T2 Color Atlas and Synopsis of Vascular Diseases YR 2015 FD 2015 PB McGraw-Hill Medical PP New York, NY SN 9780071749541 LK accesssurgery.mhmedical.com/content.aspx?aid=1105291976 RD 2024/03/28 AB A 63-year-old woman presents for evaluation of unsightly erythematous-brown plaques on her anterior shins. The lesions appeared approximately 6 months ago and are occasionally itchy. She reports that she has delightfully but unintentionally lost 30 lb in the past year and her friends tell her she always looks "startled." On examination her skin is warm and flushed and her palms are sweaty, while her eyes are bulging with scleral show and proptosis of the upper eyelid. Examination reveals firm, nonpitting nodular red-brown plaques on her anterior shins and dorsal feet. She is diagnosed with hyperthyroidism with thyroid dermopathy. She is referred to endocrinology for further evaluation and definitive management of her hyperthyroidism and treated topically with daily application of a class 1 corticosteroid under occlusion; her skin lesions gradually resolve. Figures 69-1 and 69-2 show typical cases of pretibial myxedema (PTM), which is classically associated with Graves disease but can occur with other thyroid diseases.