Firm, non-pitting edematous plaques on the anterior tibia and foot

Introduction The hard non-depressed edema of the anterior and posterior pedicles is a diffuse type of mucinous edema of the anterior tibia. The anterior and posterior iliac crests are diffuse and hard non-recessed edema. Skin lesions are most common in the anterior tibial region, which can be one side at the beginning, and then the extension involves the extension of the two calves, which is somewhat symmetric. A few can also be found in the hands, arms and face, occasionally in the trunk. The lesion is round, oblong or irregularly round, swollen and firm, and the plaque without pressure is depressed, and the boundary is clear. It is waxy translucent to rose or reddish, sometimes with brown or brownish black. The surface is uneven. The hair is also thick and can be orange peel. Local sweating is often increased and the hair is thick and black. Self-feeling can be accompanied by itching or antling.

Cause

At present, the disease is considered to be a manifestation of autoimmune diseases like the exophthalmos in hyperthyroidism. The evidence is as follows:

1 The disease is almost always accompanied by diffuse hyperthyroidism, which has been considered an autoimmune disease.

2 diffuse hyperthyroidism in patients with hyperthyroidism, exophthalmos, and sputum mucus edema, LATS (long-acting thyroid stimulating factor) may be found in serum.

3 LATS is also present in mucus edema fluid and biopsy specimens.

4LATS is involved in the activation of lymphocytes to promote the proliferation of fibroblasts to produce large amounts of mucin. However, the specific pathogenesis remains to be further studied.

an examination

Related inspection

Tension stress test

[Clinical manifestations and diagnosis]

Skin lesions are most common in the anterior tibial region, which can be one side at the beginning, and then the extension involves the extension of the two calves, which is somewhat symmetric. A few can also be found in the hands, arms and face, occasionally in the trunk. The lesion is round, oblong or irregularly round, swollen and firm, and the plaque without pressure is depressed, and the boundary is clear. It is waxy translucent to rose or reddish, sometimes with brown or brownish black. The surface is uneven. The hair is also thick and can be orange peel. Local sweating is often increased and the hair is thick and black. Self-feeling can be accompanied by itching or antling.

Often accompanied by hyperthyroidism and exophthalmia. Thyroid extremity disease is not common, characterized by: finger (toe) bone and distal long periosteal hyperplasia, the soft tissue swelling on it, the clinical manifestations of the drumstick-like toe.

According to the wax-like translucent plaque in the front of the sputum, the local bristles are thick and black, accompanied by hyperthyroidism, and the general diagnosis is not difficult.

[Laboratory Inspection]

Serum LATS titers increased. Thyroid function tests (including basal metabolic rate, radioactivity) 'I and 1r3) often suggest hyperthyroidism.

Differential diagnosis

Pre-temporal black spot: Pre-ankle black spot is one of the complications of diabetes, itchy skin, prone to long lice, and a characterization of the pre-anterior dark spot. A black piece on the leg. It can't be quickly eliminated, it hasn't disappeared yet, it's another one, it's black. The front of the legs is black. Many people with diabetes have this kind of performance.

Acupressure edema before fistula: Acupressure edema is one of the clinical manifestations of primary deep venous insufficiency of the lower extremity. Primary deep venous insufficiency is caused by Kistner (1980). The new category of venous lesions proposed firstly is mainly due to the free edge elongation, relaxation, and sagging of the valve in the deep vein, so that when the blood flows backward under gravity, the two opposite leaflets cannot be closely aligned in the middle of the lumen. This causes deep venous reflux disease, resulting in congestion and high pressure in the venous system of the lower extremities, leading to a series of clinical symptoms and signs.

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