Question

during an examination of a patient with known graves disease, the clinician notices non - pitting, doughy subcutaneous nodules in the pretibial areas. this finding is best explained by: chronic hypertrophic scarring of the soft tissues lymphatic obstruction leading to localized edema inflammation due to autoimmune dermatitis fluid retention secondary to renal impairment proteoglycan deposition in the soft tissues

Explanation:

Pretibial myxedema in Graves' disease is due to proteoglycan deposition in the soft - tissues. It presents as non - pitting, doughy subcutaneous nodules. Chronic hypertrophic scarring is not the cause. Lymphatic obstruction causes pitting edema. Autoimmune dermatitis is not the main mechanism. Renal impairment - related fluid retention is not responsible for this specific finding.

Answer:

Proteoglycan deposition in the soft tissues