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A 45-year-old woman presented with a two-year history of asympto­matic, firm, nonpitting, flesh-colored, multiple nodules and plaques on both lower legs and feet. She had been diagnosed with Graves’ disease three years earlier. The patient had exophthalmos as well as ophthalmopathy. On laboratory evaluation, thyroid-stimulating hormone (TSH) was markedly low titer at <0.05 µU/mL, TSH-receptor antibody was extremely high at 73.8%, and antithyroglobulin antibodies were negative.

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