This is a particularly challenging case. The images above are from a patient who noted acute onset nonpitting edema of the arm. This later became a symmetric induration with puckering, giving the irregular, woody texture of the skin of an orange peel. The disease spares the hands and feet. When you raise the affected limb, visible indentations appear along the course of the superficial veins. The patient also complains of arthritis. Labs surprise you with an eosinophilia.
Challenge: What is your diagnosis?
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