Thickening of the skin is most commonly seen in myxedema and scleroderma. The association of Raynaud's phenomena will help distinguish scleroderma. Thickening of the skin of the lower legs may also be seen in lymphedema, carcinoid syndrome, and vascular insufficiency. Localized thickening in the pretibial area may be seen in hyperthyroidism. Thickening of the skin of the face is seen in Chagas' disease and porphyria cutanea tarda.
In cases of diffuse thickening of the skin, a thyroid profile with T 3 , T 4 , and TSH should be done. This should also identify hypothyroidism. A positive ANA test with a speckled pattern will help identify scleroderma, but a skin biopsy should also be done. An antisclerodermal antibody titer is also useful if available. Esophageal motility studies will be helpful in early diagnosis. A skin biopsy will help identify many of the other conditions mentioned above. Urine for porphyrins will help identify porphyria.
Review other book chapters online related to Seborrheic keratosis:
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9 
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