Case A 51-year-old male school teacher presented with progressive swelling of the lower legs. Initially, he ignored the changes, assuming they resulted from standing all day. However, the swelling did not recede overnight and his shins are lumpy. He is otherwise fit and has a family history of varicose veins and diabetes. Occasionally he consumes paracetamol for headaches. Examination Bilateral pigmented plaques were observed on the anterior shins. Pigmentation is worse on the left side than the right.
Associated swelling does not pit on firm pressure No evidence of varicose veins was observed No obvious swelling in his neck. Scalp and nails look normal. What investigations would you suggest in this patient? What is the most probable diagnosis? *This case is from Docplexus editorial team for educative purpose only. Source: 100 Cases In Dermatology.
