Evaluation of cutaneous manifestations in patients under treatment with thyroid disease

Abstract

Amaç: Tiroid hastalıkları sıklıkla saç, deri ve tırnaklarda çeşitli bulgulara neden olur. Bu bulguların bazıları tiroid hastalığının tedavisi ile gerileyebilir. Bu çalışmada tedavi altındaki tiroid hastalarında deri bulgularını değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu kesitsel çalışmaya tedavi altındaki 97 tiroid hastası ve 50 sağlıklı kontrol dahil edildi. Tiroid hastalığı otoimmün ve nonotoimmün olarak sınıflandırıldı. Tüm deri bulguları ve dermatolojik hastalıklar kaydedildi. Bulgular: Hasta grubunun 56'sında (%57,7) otoimmün, 41'inde (%43,3) non-otoimmün tiroid hastalığı mevcuttu. Seksen dört (%86,4) hasta tiroid hormon tedavisi, 13 (%23,6) hasta anti-tiroid tedavi alıyordu. Otoimmün grubun %73,2'sinde, non-otoimmün grubun %71,4'ünde ve kontrol grubunun %52'sinde en az bir deri bulgusu vardı (p=0,05). Kseroz (p=0,026), kaşıntı (p=0,00), fasiyal eritem (p=0,036), flushing (p=0,004), kuru saç (p=0,008), kırılgan tırnaklar (p=0,02), kuru tırnaklar (p=0,013) ve tırnaklarda uzunlamasına çizgiler (p=0,02) otoimmün grupta non-otoimmün ve kontrol grubuna göre daha sıktı. Alopesi (p=0,00) non-otoimmün grupta daha sıktı. Ayrıca, hasta grubunda diffüz hiperhidroz (p=0,016), tırnaklarda incelme (p=0,059) ve rozase hastalığı (p=0,03) kontrol grubundan daha sıktı. Tiroid hormon tedavisi alanlarda, en az bir deri bulgusu, kserozis ve çeşitli tırnak bulguları anti-tiroid tedavi alanlara göre daha sıktı. Ancak istatistiksel olarak anlamlı bir fark yoktu. Background and Design: Thyroid diseases often cause various findings in hair, skin and nails. Some of them may be regressed by the treatment of thyroid disease. We aimed to evaluate the cutaneous manifestations in patients with thyroid disease under treatment. Materials and Methods: This cross-sectional study included 97 consecutive patients with thyroid disease under treatment and 50 healthy controls. Thyroid disease was classiffied as autoimmune and non-autoimmune. All skin findings and dermatological diseases were recorded. Results: Of the patient group, 56 (57.7%) had autoimmune, 41 (43.3%) had non-autoimmune thyroid disease. Eighty-four (86.4%) patients were under thyroid hormone therapy and 13 (23.6%) patients were under anti-thyroid therapy. 73.2% of the autoimmune group, 71.4% of non-autoimmune group and 52% of the control group had at least one cutaneous manifestation (p=0.05). Xerosis (p=0.026), pruritus (p=0.00), facial erythema (p=0.036), flushing (p=0.004), dry hair (p=0.008), brittle nails (p=0.02), dry nails (p=0.013) and longitudinal streaking on nails (p=0.02) were more frequent in the autoimmune group than in the non-autoimmune and control group. Alopecia (p=0.00) was more frequent in the non-autoimmune group. Furthermore diffuse hyperhidrosis (p=0.016), thinning of nails (p=0.059) and rosacea disease (p=0.03) were more common in the patient group than in the control group. At least one cutaneous manifestation, xerosis and various nail findings were more common in patients under thyroid hormone therapy than in patients under anti-thyroid therapy, but t...

Nail Changes Associated With Thyroid Disease

“…Additionally, pruritus affected up to 28% (n=32) 11 of hypothyroid and 16.0% (n=120) 7 of hyperthyroid patients and was more common in autoimmune (41%) vs nonautoimmune (32%) thyroid patients. 8 Weight gain was seen in 72% of hypothyroid patients (n=32), 11 and soft hair and skin were reported in 83.3% and 66% of hyperthyroid patients (n=120), respectively. 7 Flushing was a less common physical finding in thyroid patients (usually affecting <10%); however, it also was reported in 17.1% of autoimmune and 57.1% of hyperthyroid patients from 2 separate studies.…”

“…Nail changes in patients with thyroid disease were reported in 8 studies (7 cross-sectional, 1 retrospective cohort) and are summarized in the Table. [4][5][6][7][8][9][10][11] The mean age was 41.2 years (range, 5-80 years), with a higher representation of females (range, 70%-94% female).…”

“…7 Nail brittleness was a frequently reported nail change in thyroid patients (4/8 studies, 50%), most often seen in 22% of autoimmune patients, 19.6% of nonautoimmune patients, 13.9% of hypothyroid patients, and 9.2% of hyperthyroid patients. 5,8 For comparison, brittle nails presented in 10.8% of participants in a control group. 5 Brittle nails in thyroid patients often are accompanied by other nail findings such as thinning, onycholysis, and pitting.…”

“…Xerosis was most common in hypothyroid disease (57.2%; n=460). 4 In 2 studies, 8,9 alopecia affected approximately 70% of autoimmune, nonautoimmune, and hyperthyroid patients. Hair loss was reported in 42.6% (n=460) 4 and 33.0% (n=36) 9 of hypothyroid patients.…”

“…7 Flushing was a less common physical finding in thyroid patients (usually affecting <10%); however, it also was reported in 17.1% of autoimmune and 57.1% of hyperthyroid patients from 2 separate studies. 8,9…”