Question: Can you identify this condition?

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

1. Erythema nodosum

2. Stasis dermatitis

3. Diabetic dermopathy

4. Pretibial myxedema

Answer on page 369

• Copyright© the College of Family Physicians of Canada