Case Report
Dössekker’s atypical tuberous myxoedema, a rare variant of scleromyxoedema Faisal R Ali, Pauline Ho, Iskander H Chaudhry, Luisa Motta, Robert J G Chalmers Lancet 2015; 385: 2222 Dermatology Department (F R Ali MA, R J G Chalmers FRCP), Kellgren Centre for Rheumatology (P Ho FRCP), and Department of Cellular Pathology (I H Chaudhry FRCPath), Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK; and Department of Cellular Pathology, Salford Royal NHS Foundation Trust, Eccles, UK (L Motta FRCPath) Correspondence to: Dr Robert J G Chalmers, Dermatology Centre, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester M6 8HD, UK [email protected]
In January, 2012, a previously well 49-year-old man of Sudanese descent presented with a 5 day history of progressive painful swelling of the face, particularly affecting the eyelids and periorbital tissues and hands. He took no drugs and had no allergies. He had travelled to Sudan 6 months previously but had had no known contact with tuberculosis. A presumptive diagnosis of angioedema was made but the swellings did not respond to multiple antihistamines, several doses of intramuscular adrenaline, high doses of systemic corticosteroids, and broad spectrum intravenous antibiotics. Initial investigations showed mildly raised inflammatory markers (C-reactive protein 43 mg/L; normal
Dössekker’s atypical tuberous myxoedema, a rare variant of scleromyxoedema Faisal R Ali, Pauline Ho, Iskander H Chaudhry, Luisa Motta, Robert J G Chalmers Lancet 2015; 385: 2222 Dermatology Department (F R Ali MA, R J G Chalmers FRCP), Kellgren Centre for Rheumatology (P Ho FRCP), and Department of Cellular Pathology (I H Chaudhry FRCPath), Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK; and Department of Cellular Pathology, Salford Royal NHS Foundation Trust, Eccles, UK (L Motta FRCPath) Correspondence to: Dr Robert J G Chalmers, Dermatology Centre, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester M6 8HD, UK [email protected]
In January, 2012, a previously well 49-year-old man of Sudanese descent presented with a 5 day history of progressive painful swelling of the face, particularly affecting the eyelids and periorbital tissues and hands. He took no drugs and had no allergies. He had travelled to Sudan 6 months previously but had had no known contact with tuberculosis. A presumptive diagnosis of angioedema was made but the swellings did not respond to multiple antihistamines, several doses of intramuscular adrenaline, high doses of systemic corticosteroids, and broad spectrum intravenous antibiotics. Initial investigations showed mildly raised inflammatory markers (C-reactive protein 43 mg/L; normal
