Atypical presentation of infiltrative thyroid dermopathy

Rice, Scott; Peden, N. R.; McGlynn, Stephen; Morton, C.A.

doi:10.1111/j.1365-2230.2008.03109.x

Cited by 15 publications

(2 citation statements)

References 12 publications

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“…При редко встречающейся слоновости имеют место выраженный лимфостаз и узловое перерождение тканей [16]. Описаны случаи тиреоидной дермопатии предплечья, плеча, ладони, верхней части спины и шеи после предшествующей травмы, а также в местах шрамов, ожогов [11,[17][18][19] [20]. ПМ чаще возникает после манифестации эндокринной офтальмопатии, в течение первых 2 лет с момента выявления гипертиреоза, однако описаны случаи появления ПМ спустя многие годы после дебюта БГ [21].…”

Section: распространенность клиническая картина и особенности теченияunclassified

Pretibial myxedema: pathogenetic features and clinical aspects

Sabanova

Fadeyev

Потекаев

et al. 2019

Probl Endokrinol (Mosk)

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Pretibial myxedema (PTM) or thyroid dermopathy is a rare extrathyroidal manifestation of Graves disease. The condition is accompanied by mucinous skin changes, mainly in the anterior tibial surface. Severe forms may lead to lymphatic congestion and disability. Prolonged and intense autoimmune aggression is supposed to be necessary for PTM manifestation. However, data on the role of TSHR antibodies in the development of thyroid dermopathy are very ambiguous; evidence of IGF-1 receptor involvement in the pathogenesis was reported recently. Typically, PTM is localized on the anterior and lateral surfaces of both tibias and can be represented by diffuse, tumorous, plaque-like, or elephantiasic forms. Currently, early diagnostics involves regular preventive examination of the pretibial area. A diagnostic biopsy is indicated only in complex cases. Maintaining euthyroidism, smoking cessation, preventing injuries, and avoiding tight shoes that disturb lymphatic drainage are measures reducing the risk of PTM in GD patients. Currently, there are no accepted clinical guidelines for the diagnosis and treatment of thyroid dermopathy. This review provides the recent scientific data on etiopathogenesis and management of patients with PTM.

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Section: распространенность клиническая картина и особенности теченияunclassified

Pretibial myxedema: pathogenetic features and clinical aspects

Sabanova

Fadeyev

Потекаев

et al. 2019

Probl Endokrinol (Mosk)

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“…PTM has also been reported, but much less than, to occur on the upper extremities, particularly in areas exposed to repeated trauma, surgical scars, vaccination sites, and burn scars. 8 – 10 In addition, buttock nodules and ureteral myxedema have been reported in patients with GD. 11 , 12 PTM patients with mild condition are usually asymptomatic, but severe cases may induce functional problems such as difficulty in dressing and wearing socks and shoes.…”

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confidence: 99%

Treatment of pretibial myxedema with intralesional immunomodulating therapy

Ren

Deng

et al. 2017

TCRM

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ObjectiveLocal immune regulation therapy has been one of the therapeutic methods used for the treatment of autoimmune thyroid disease in patients with pretibial myxedema (PTM). However, the poor response rate and high recurrence rate are still major problems. Whether a premixed corticosteroid, compound betamethasone, could enhance remission rate and decrease recurrence rate in patients with PTM was investigated in the present study.Subjects and methodsWe have performed a clinical utility observation of compound betamethasone with intralesional injections based on basic thyroid disease treatment in 32 PTM patients between January 2008 and August 2016. The patients were followed up for 2 years, and the clinical outcomes and side effects were calculated and analyzed.ResultsAll patients had a complete remission after different times of injection. A total of 21.7% patients had complete remission with one time of injection, 34.8% with two times of injection, 17.4% with three times of injection, 4.3% with four times of injection, and 4.3% with five times of injection. In all, 56.3% patients with a disease duration of <6 months had complete remission after a 1-month treatment, 37.5% patients with a disease duration between 6 months and 12 months had complete remission after a 2-month treatment, 3.1% patients with a disease duration of 2 years had complete remission after a 5-month treatment, and 3.1% with a disease duration of 5 years had complete remission after a 7-month treatment.ConclusionCompound betamethasone with multipoint intralesional injection is a feasible, effective, and secure novel strategy in the treatment of PTM.

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Disorders of the Lymphatic Vessels

Mortimer

Gordon

2016

Rook's Textbook of Dermatology, Ninth Edition

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Lymphatic dysfunction interferes with fluid homeostasis, tissue immunity and peripheral fat mobilization. Any chronic oedema represents lymphatic failure. If impaired lymph drainage is solely responsible, then lymphoedema results. This produces characteristic skin changes known as elephantiasis as well as increased fat deposition in the subcutaneous tissues. Impaired immune cell trafficking results in an increased risk of infection, particularly cellulitis/erysipelas, which often becomes recurrent. This chapter describes the clinical consequences of lymphatic dysfunction and in particular the impact on the skin and subcutaneous tissues. The sections are divided according to common clinical presentations.

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Atypical presentation of infiltrative thyroid dermopathy

Cited by 15 publications

References 12 publications

Pretibial myxedema: pathogenetic features and clinical aspects

Pretibial myxedema: pathogenetic features and clinical aspects

Treatment of pretibial myxedema with intralesional immunomodulating therapy

Disorders of the Lymphatic Vessels

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