An Asymptomatic Erythematous Plaque on the Chin of a 45-year-old Woman
摘要
A 45-year-old woman had asymptomatic skin lesions for several months. She was healthy except for a history of hyperthyroidism 10 years previously treated with thyroidectomy. She then became hypothyroid and had been maintained on thyroxine replacement. She had no congenital anomalies and her family history was non-contributory. Physical examination revealed a slightly erythematous, nontender plaque on the chin (Fig. 1). She had areas of induration and non-pitting edema on her shins and upper back. The results of blood tests, including thyroxine and thyroid stimulating hormone, were within normal limits. Myxedema was suspected, and a 4-mm punch biopsy specimen was obtained from the chin lesion. Histologically, the dermis contained randomly oriented, mature, striated muscle fibers with admixed mesenchymal elements including adipose tissue, vessels, and collagen (Fig. 2), findings consistent with a diagnosis of RMH. The patient was offered CO2 resurfacing or excision, but she declined since the plaque was benign and cosmetically inconspicuous.