SKIN THICKENING

SKIN THICKENING: Excerpt from Differential Diagnosis in Primary Care

Diffuse thickening of the skin is typical of myxedema, whereas thickening of the skin of the hands and face is also found in scleroderma and hereditary osteoarthropathy. Thickening of the skin of the lower legs is found in lymphedema and carcinoid syndrome. If the thickening is primarily localized to the face, consider the possibility of Chagas disease and porphyria cutanea tarda.

Approach to the Diagnosis

If myxedema is suspected, a thyroid-stimulating hormone (TSH) test and FT₄ test can be ordered. If scleroderma is suspected, order an ANA, anticentromere antibody titer or a skin biopsy. Urine for porphyrins will help to identify porphyria. Carcinoid syndrome can be identified by a urine test for 5-hydroxyindole acetic acid (HIAA).

Book Source Details

• Book Title: Differential Diagnosis in Primary Care
• Author(s): R. Douglas Collins MD, FACP
• Year of Publication: 2007
• Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.

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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Differential Diagnosis in Primary Care Authors: R. Douglas Collins MD, FACP Publisher: Lippincott Williams & Wilkins Copyright: 2007 ISBN: 0-7817-6812-8

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