CASES IN DERMATOLOGY (1)
AN OVERWEIGHT TEENAGER WITH THICKENED SKIN AROUND HER NECK History A 13-year-old girl attends your clinic with her mother. She is complaining of skin changes affecting her neck , which have been progressively worsening over the past 18 months . In particular the changes are leading to name-calling at school with her peers saying her neck is ‘ dirty ’. Her school attendance for the last term was only 87 per cent. She is a very quiet girl and there is little eye contact through the consultation. Both she and her mother acknowledge that she is overweight . Her menarche was at the age of 11 years and 3 months , her menses are irregular . She is not on medication . She is an only child. Her mother has type 2 diabetes , hypertension and is also overweight , her father suffers from asthma . Examination Her height is 163 cm and weight 97.5 kg – a body mass index ( BMI ) of 37 – and blood pressure 140/85 mmHg. She has symmetrical hyperp...
