Pretibial Myxedema

Warthin, Thomas A.

doi:10.1001/archinte.1957.00260080145029

Cited by 14 publications

(5 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The temporal relationship between the thyrotoxic state and the appearance of pretibial myxoedema would appear to be variable as one patient in the present series developed the lesions only 2 weeks after treatment with carbimazole while the remaining two developed the lesions after treatment with 131. All these lesions corresponded to those described by Gimlette (1960) and Warthins and Boshell (1957). The more severe form, in which the skin is elephantiasis-like (Gimlette, 1960;Warthins and Boshell, 1957;Shasky and Nelson, 1966), was not seen in the present series.…”

Section: Discussionsupporting

confidence: 87%

“…All these lesions corresponded to those described by Gimlette (1960) and Warthins and Boshell (1957). The more severe form, in which the skin is elephantiasis-like (Gimlette, 1960;Warthins and Boshell, 1957;Shasky and Nelson, 1966), was not seen in the present series. Gorman (1972) stated that it is rare to see pretibial myxoedema in a patient without ophthalmopathy, and Warthins and Boshell (1957) thought that pretibial myxoedema may herald the onset of malignant exophthalmos.…”

Section: Discussionsupporting

confidence: 87%

“…The more severe form, in which the skin is elephantiasis-like (Gimlette, 1960;Warthins and Boshell, 1957;Shasky and Nelson, 1966), was not seen in the present series. Gorman (1972) stated that it is rare to see pretibial myxoedema in a patient without ophthalmopathy, and Warthins and Boshell (1957) thought that pretibial myxoedema may herald the onset of malignant exophthalmos. All three patients in the present study had bilateral exophthalmos but none progressed to the malignant stage.…”

Section: Discussioncontrasting

confidence: 73%

“…Case 3 became hypothyroid after treatment with two doses of 131I. Warthins and Boshell (1957) postulated that rapid reversion from the hyperthyroid state to the euthyroid state may be a factor precipitating pretibial myxoedema. He also found that injection of triiodothyronine into the pretibial myxoedema lesions of one of his patients resulted in a temporary disappearance of the lesions; he concluded that the area of pretibial myxoedema is a true area of local hypothyroidism owing to the insensitivity of local tissues to active thyroid hormone.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Thyrotoxic pretibial myxoedema in Asian patients in Singapore

Kee¹,

Cheah²

1975

Postgraduate Medical Journal

View full text Add to dashboard Cite

SummaryOver a 5-year period, three cases of thyrotoxic pretibial myxoedema were encountered. The incidence of pretibial myxoedema in Chinese thyrotoxic patients in Singapore was 0-7yo (03y. in females and 1F6% in males). One of the three patients also had thyroid acropachy. The incidence of thyrotoxic pretibial myxoedema in Singapore is compared with that in the literature and the aetiology briefly reviewed.PRETIBIAL myxoedema is an unusual complication of thyrotoxicosis and there is scanty knowledge of its incidence. Gimlette (1960) reported an incidence of 4*3 % while Shasky and Nelson (1966) found an incidence of 1 %. There has been no previous report of the incidence of thyrotoxic pretibial myxoedema in Asians or in the tropics. This paper describes the incidence of pretibial myxoedema in Singapore over a 5-year period and the clinical features observed. Materials and methodsThere were 479 cases of thyrotoxicosis seen in the Department of Medicine (Unit I), University of Singapore, over a 5-year period, 1968Singapore, over a 5-year period, -1972. Ofthese, 322 were female and 157 were male. There were 435 Chinese, thirty-one Malays, six Indians and seven of other ethnic groups. Pretibial myxoedema was carefully looked for in all cases and it was found in three Chinese (diagnosis confirmed by skin biopsy). Two of these were male, giving an incidence of 1 6% of 129 Chinese thyrotoxic males, and one was female, giving an incidence of 0-3y. of Chinese thyrotoxic females. The overall incidence of pretibial myxoedema in Chinese thyrotoxic patients, male and female, was 0'7%/O. In addition, two of the patients had diffuse thickening of the skin and subcutaneous tissues but skin biopsies were not diagnostic; these two cases are excluded from the study. The three cases are reported in detail below. Case reports Case IA 47-year-old Chinese male storekeeper was seen Fifteen months later, he relapsed. The thyroid uptake of 131I at 4 hr was 43%O and at 24 hr, 49%. At this stage, he was noted to have bilateral circumscribed swellings over both shins. Skin biopsy of one of the swellings over the shin confirmed the diagnosis of pretibial myxoedema; there was separation of the collagen fibres probably due to interstitial oedema and mucinous degeneration of some fibres. Thyroid antibodies (tanned red cell agglutination) were positive 1: 25, and antimicrosomal antibodies were positive. The serum immunoglobulins were IgG 1520 mg/100 ml (normal 598-1086 mg/100 ml; Chew, Yu and Wee, 1969); IgA 130 mg/100 ml (normal 91-399 mg/100 ml) and IgM 26 mg/100 ml (normal 44-100 mg/100 ml). He was then treated with carbimazole for another 4 months; his pretibial myxoedema remained unchanged. A 55-year-old Chinese man presented with congestive cardiac failure. He was found to be thyrotoxic. His thyroid gland was twice normal size and was firm and nodular and he had Grade 1 bilateral exophthalmos. There was no clubbing of the fingers or toes. The resin uptake of triiodothyronine was 195% (normal 75-115°/) and his total serum thyroxine was 12-...

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Thyrotoxic pretibial myxoedema in Asian patients in Singapore

Kee¹,

Cheah²

1975

Postgraduate Medical Journal

View full text Add to dashboard Cite

show abstract

“…Although autoimmune-associated manifestations may be specific to Graves' disease, thyrotoxicosis in general may result in skin sequelae. Starting in the 1950s, there were attempts to use parenteral and topical tri-iodothyronine (T 3 ) to treat pretibial myxedema in Graves' patients [4–7]. In all cases, lesions improved with topical or intralesional steroids which ended further study of thyroid hormone action.…”

Section: Introductionmentioning

confidence: 99%

Thyroid Hormone and Wound Healing

Safer

2013

Journal of Thyroid Research

View full text Add to dashboard Cite

Although thyroid hormone is one of the most potent stimulators of growth and metabolic rate, the potential to use thyroid hormone to treat cutaneous pathology has never been subject to rigorous investigation. A number of investigators have demonstrated intriguing therapeutic potential for topical thyroid hormone. Topical T3 has accelerated wound healing and hair growth in rodents. Topical T4 has been used to treat xerosis in humans. It is clear that the use of thyroid hormone to treat cutaneous pathology may be of large consequence and merits further study. This is a review of the literature regarding thyroid hormone action on skin along with skin manifestations of thyroid disease. The paper is intended to provide a context for recent findings of direct thyroid hormone action on cutaneous cells in vitro and in vivo which may portend the use of thyroid hormone to promote wound healing.

show abstract

Hyperthyroidism, Pretibial Myxedema, and Clubbing

Malkinson¹

1963

Arch Dermatol

View full text Add to dashboard Cite

Pretibial Myxedema

Cited by 14 publications

References 4 publications

Thyrotoxic pretibial myxoedema in Asian patients in Singapore

Thyrotoxic pretibial myxoedema in Asian patients in Singapore

Thyroid Hormone and Wound Healing

Hyperthyroidism, Pretibial Myxedema, and Clubbing

Contact Info

Product

Resources

About