Thyroid dermopathy—a diagnostic clue of hidden hyperthyroidism

Dhali, Tapan Kumar; Chahar, Monica

doi:10.4161/19381980.2014.981078

Cited by 19 publications

(37 citation statements)

References 19 publications

(29 reference statements)

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“…Stimulation of fibroblasts by anti-TSHR antibodies along with mechanical factors and venous stasis causes accumulation of mucin. Trauma and injury may lead to the activation of T cells and the initiation of an antigen specific response, in this case the activation of fibroblasts and production of glucosaminoglycans (GAGs) ( 119 ).…”

Section: Anti-thyroid Antibody Types: the Key To The Diagnosismentioning

confidence: 99%

Thyroid Autoimmunity: Role of Anti-thyroid Antibodies in Thyroid and Extra-Thyroidal Diseases

2017

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Autoimmune diseases have a high prevalence in the population, and autoimmune thyroid disease (AITD) is one of the most common representatives. Thyroid autoantibodies are not only frequently detected in patients with AITD but also in subjects without manifest thyroid dysfunction. The high prevalence raises questions regarding a potential role in extra-thyroidal diseases. This review summarizes the etiology and mechanism of AITD and addresses prevalence of antibodies against thyroid peroxidase, thyroid-stimulating hormone receptor (TSHR), and anti-thyroglobulin and their action outside the thyroid. The main issues limiting the reliability of the conclusions drawn here include problems with different specificities and sensitivities of the antibody detection assays employed, as well as potential confounding effects of altered thyroid hormone levels, and lack of prospective studies. In addition to the well-known effects of TSHR antibodies on fibroblasts in Graves’ disease (GD), studies speculate on a role of anti-thyroid antibodies in cancer. All antibodies may have a tumor-promoting role in breast cancer carcinogenesis despite anti-thyroid peroxidase antibodies having a positive prognostic effect in patients with overt disease. Cross-reactivity with lactoperoxidase leading to induction of chronic inflammation might promote breast cancer, while anti-thyroid antibodies in manifest breast cancer might be an indication for a more active immune system. A better general health condition in older women with anti-thyroid peroxidase antibodies might support this hypothesis. The different actions of the anti-thyroid antibodies correspond to differences in cellular location of the antigens, titers of the circulating antibodies, duration of antibody exposure, and immunological mechanisms in GD and Hashimoto’s thyroiditis.

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Section: Anti-thyroid Antibody Types: the Key To The Diagnosismentioning

confidence: 99%

Thyroid Autoimmunity: Role of Anti-thyroid Antibodies in Thyroid and Extra-Thyroidal Diseases

2017

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“…Histopathologically, reduced collagen fibers, extensive mucin deposition, reduced elastic tissue, and edema are the characteristic findings. 3 Other rarely documented pathological features include hyperkeratosis, acanthosis, and papillomatosis. 3 The pathogenesis of thyroid dermopathy is summarized in Figure 1.…”

Section: Pathogenesismentioning

confidence: 99%

“…3 Other rarely documented pathological features include hyperkeratosis, acanthosis, and papillomatosis. 3 The pathogenesis of thyroid dermopathy is summarized in Figure 1.…”

Section: Pathogenesismentioning

confidence: 99%

“…Thyroid dermopathy, sometimes called pretibial myxedema, is found in about 0.5-4.3% of patients with Graves' disease. 3 It is an infiltrative dermopathy diagnosed in the presence of typical symptoms and signs, biochemical evidence of thyroid dysfunction or evidence of the characteristic autoimmune markers, as well as pathological findings in the skin. 3 It manifests in various ways, affecting the skin of different parts of the body.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Profiles of Thyroid Dermopathy: A Dermato-Endocrinological Perspective

Azeez

Egbu

2020

Journal of Interdisciplinary Medicine

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Thyroid disorders sometimes have extra-thyroidal manifestations. Hyperthyroidism is a clinical syndrome resulting from excessive secretion of thyroid hormones. The most common cause is Graves’ disease. About 0.5–4.3% of patients with Graves’ disease have an infiltrative dermopathy called thyroid dermopathy, which is due to excessive deposition of glycosaminoglycans from activated fibroblasts. Skin fibroblasts are activated by thyroid stimulating hormone receptor antibodies the whole process being initiated by T lymphocytes. Rarely, thyroid dermopathy is also found in other thyroid disorders such as Hashimoto thyroiditis. The diffuse non-pitting edema variant is the most common clinical presentation. Other variants include the nodular, plaque, mixed, and elephantiasis types. Usually, the main concerns of the patients are cosmetic, discomfort, and difficulty in wearing shoes. Thyroid dermopathy usually presents after the diagnosis of Graves’ disease, but it may also present together or sometime after this condition. Rarely, thyroid dermopathy presents before the diagnosis of Graves’ disease is made. Apart from the shin and feet, other sites that can be affected include the arms, forearms, back, thighs, pinna, and nose. The management is multidisciplinary, involving dermatologists and endocrinologists. Usually, controlling the thyroid dysfunction does not translate into regression of the skin lesions. However, many patients have their thyroid dermopathy regress spontaneously, while others usually require local therapy. Other therapeutic options include systemic therapy such as pentoxifylline, compressive physiotherapy, and surgery.

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“…22,23 Heart failure in patients with hyperthyroidism is a complex problem with many facets. 24 Its mechanism and management are well described elsewhere. 24,25 Fig.…”

Section: Figurementioning

confidence: 99%

“Eyeing” the Cause of Heart Failure: Visible Telltale Clues

2016

Texas Heart Institute Journal

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Thyroid dermopathy—a diagnostic clue of hidden hyperthyroidism

Cited by 19 publications

References 19 publications

Thyroid Autoimmunity: Role of Anti-thyroid Antibodies in Thyroid and Extra-Thyroidal Diseases

Thyroid Autoimmunity: Role of Anti-thyroid Antibodies in Thyroid and Extra-Thyroidal Diseases

Clinical Profiles of Thyroid Dermopathy: A Dermato-Endocrinological Perspective

“Eyeing” the Cause of Heart Failure: Visible Telltale Clues

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