A 33‐year‐old nurse presents with a history of weight gain, decreased energy, and menorrhagia
over the past several months. Review of her family history reveals Hashimoto thyroiditis and
hypothyroidism in four female first‐degree relatives (her mother and three sisters). Which of the
following skin findings best supports a diagnosis of clinical hypothyroidism?
a) Discoid rash, alopecia, oral ulcers, and Raynaud phenomenon
b) Dry skin, myxedema, alopecia of the eyebrows, and brittle nails
c) Thickened, taut skin with sclerodactyly and telangiectasia
d) Warm moist skin, hyperpigmentation, and pretibial myxedema
e) Spider angiomas, telangiectasia, palmar erythema, and Terry nails
