Insidious-Onset Indurated Plaques on the Shins

Rishi Agrawal; Daniel Knabel; Anthony P Fernandez

doi:10.3390/dermatopathology8020024

Insidious-Onset Indurated Plaques on the Shins

Dermatopathology (Basel). 2021 Jun 6;8(2):185-189. doi: 10.3390/dermatopathology8020024.

Authors

Rishi Agrawal¹, Daniel Knabel^{2

3}, Anthony P Fernandez^{2

3}

Affiliations

¹ Imperial College School of Medicine, Imperial College London, South Kensington, London SW7 2BU, UK.
² Departments of Dermatology, Cleveland Clinic, Cleveland, OH 44195, USA.
³ Departments of Pathology, Cleveland Clinic, Cleveland, OH 44195, USA.

Abstract

A 64-year old male presented with a several-year history of an insidious-onset tender, itchy and xerotic rash on his lower legs. Past medical history was significant for Graves' disease and Graves' ophthalmopathy. The examination revealed peau d'orange-appearing plaques on his shins clinically consistent with pretibial myxedema. A punch biopsy showed separation of collagen bundles with extensive dermal mucin deposition, confirming the diagnosis of pretibial myxedema. After initially failing treatment with a topical clobetasol 0.05% ointment, the patient switched to regular pentoxifylline and triamcinolone 0.1% ointment under occlusion. He remains under follow-up.

Keywords: Graves’ disease; mucin; pretibial myxedema.

Publication types

Case Reports