TITLE:
Elephantiasic Pretibial Myxoedema in a Patient with Graves’ Disease
AUTHORS:
Ruzhi Zhang, Yuhua Yang, Wenyuan Zhu
KEYWORDS:
Pretibial Myxoedema (PM), Graves’ Disease
JOURNAL NAME:
Journal of Cosmetics, Dermatological Sciences and Applications,
Vol.5 No.4,
December
3,
2015
ABSTRACT: Pretibial myxoedema (PM) is a late and rare manifestation of autoimmune
thyroiditis, particularly in patients with Graves’ disease. It occurs in 0.5%
to 4.3% of patients [1], and is usually associated with high levels of
thyroid hormones. The classification of PM includes four forms: non-pitting
edema; plaque; nodular; or elephantiasis [1]. Mild PM often regresses spontaneously, but
the severe, elephantiasic variant is typically progressive and refractory to
treatment. Elephantiasic pretibial myxoedema (EPM) is characterized by massive
edema, skin fibrosis and verrucous nodule formation, and it clinically
resembles lymphedema. Herein, we describe a man with Graves’ disease presenting
with EPM for nearly 2 years. Although advanced cases have been described in the
literature, to our knowledge, none have reached this level of severity.