<prompt> Non pitting edema is seen in ?Congestive cardiac failureMyxedemaLiver failureRenal failure  <response>: A consequence of prolonged hypothyroidism is increased dermal infiltration of glycosaminoglycans mucopolysaccharides, hyaluronic acid and chondroitin sulphate which traps water, giving rise to skin thickening without pitting myxedema. Typical features include a puffy face with edematous eyelids and nonpitting pretibial edema. Reference : page 2291 Harrisons Principles of Internal Medicine 19th edition and page 743 Davidsons Principles and practice of Medicine 22nd edition 