Shin Lesions

Question 1

What are the differential diagnoses for shin lesions?

Answer 1

• Erythema nodosum
• Pretibial myxoedema
• Pyoderma gangrenosum
• Necrobiosis lipoidica diabeticorum

Question 2

What is erythema nodosum and what conditions is it seen in?

Answer 2

• Symmetrical, erythematous, tender, nodules which heal without scarring.
• Most common causes are:
  • Streptococcal infections
  • Sarcoidosis
  • Inflammatory bowel disease
  • Drugs(penicillins, sulphonamides,oral contraceptive pill)

Question 3

What is pretibial myxoedema and what condition is it seen in?

Answer 3

A symmetrical, erythematous lesions seen in Graves’ disease

Question 4

What is pyoderma gangrenosum?

Answer 4

• Initially small red papule
• Later deep, red, necrotic ulcers with a violaceous border
• Idiopathic in 50%, may also be seen in inflammatory bowel disease, connective tissue disorders and myeloproliferative disorders

Question 5

What is necrobiosis lipoidica diabeticorum?

Answer 5

• A shiny, painless areas of yellow/red skin typically on the shin of diabetics
• Often associated with telangiectasia