Derm Dx: A 36-year-old woman with dry skin, shin and ankle lesions and onycholysis

A 36-year-old woman presents with dry skin on her legs similar to the texture of an orange peel, lesions on the shin and ankles and onycholysis.

The patient reports sweating, palpitations and blurred vision and appears nervous and agitated. Her thyroid and one of her eyes is noticeably swollen. Family history is positive for diabetes. What's your diagnosis?

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