A 48-year-old woman presented with a 3-year history of erythematous-brown, well-demarcated plaques and nodules on a background of nonpitting edema. The lesions demonstrated a peau d’orange (orange peel) appearance and were distributed symmetrically over her lower extremities. Pressure-graded support stockings, potent topical steroids (0.05% clobetasol propionate cream), and intralesional steroid injections (10 mg/mL triamcinolone acetonide) were modestly effective. Her past medical history was remarkable for Graves disease, previously treated with radioactive iodine.
The most likely diagnosis is
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Erythema nodosum
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Stasis dermatitis
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Diabetic dermopathy
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Pretibial myxedema
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