Quiz
Leg rashes and unwell – 10 cases

Each of these patients is unwell and presented with a rash on their legs.

For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.

Each case should take approximately 2 minutes to complete. There is a list of suggested further reading material at the end of the quiz.

Case 2

A woman in her 60's presented with painful lumpy and swollen lower legs and non-pitting oedema. She was feeling exhausted, complaining of palpitations, tremor and sweating attacks. Proptosis was noted.

Markedly suppressed TSH and elevated free T3 and T4 levels were associated with high titres of thyroid antibodies. She was treated with carbimazole, and later received radioactive iodine. The discomfort of the plaques on her legs only settled when she was prescribed prednisone for several weeks.

Pretibial myxoedema

Pretibital myxoedema is due to hyperthyroidsim.

Cutaneous signs of hyperthyroidism include smooth, soft, warm and moist skin and sometimes hyperpigmentation and pruritus; diffuse alopecia and onycholysis. Graves disease may lead to pretibial myxoedema and thyroid acropachy.

Mark question

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