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A 35-year-old man, diagnosed with Graves’ disease 5 years ago, presented with recurrence of thyrotoxic symptoms and rapidly progressive non-pruritic skin lesions on legs (figure 1) for the last 6 months. He was intermittently on treatment with carbimazole. Examination was notable for grade III diffuse goitre (figure 2) and staring look. Extensive, symmetrical, nodular skin lesions were noted over both the shins suggestive of pretibial myxoedema. Investigations …
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