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Case Reports
. 2020 Jul-Aug;95(4):469-472.
doi: 10.1016/j.abd.2019.02.007. Epub 2019 Nov 25.

Successful therapeutic approach in a patient with elephantiasic pretibial myxedema

Marina Ferreira  1 , Luciana Helena Zacaron  2 , Annair Freitas do Valle  2 , Aloisio Carlos Couri Gamonal  3
Affiliations
Case Reports

Successful therapeutic approach in a patient with elephantiasic pretibial myxedema

Marina Ferreira et al. An Bras Dermatol. 2020 Jul-Aug.

Abstract

Localized pretibial myxedema is a dermopathy whose treatment is a challenge in dermatology, occurring in 0.5-4% of patients with Graves' disease. This autoimmune thyroid condition stimulates the production of hyaluronic acid and glycosaminoglycans that are deposited particularly in the pretibial region. Clinically, it presents as a localized, circumscribed, and non-depressible infiltrate in plaques. Several treatment modalities have been proposed, and their results vary, with worse response observed in severe cases. This report presents the case of a patient with elephantiasic pretibial myxedema who was subjected to intralesional corticosteroid applications, resulting in an excellent and encouraging therapeutic response that was maintained.

Keywords: Evaluation of results of therapeutic interventions; Myxedema; Steroids; Therapeutics.

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Figures

Figure 1
Figure 1
Clinical aspect of the right foot and ankle: confluent brownish nodules on waxy plaque. Hypertrichosis and hyperpigmentation are noted. First session of intralesional application of corticosteroid.
Figure 2
Figure 2
Clinical appearance of the right foot and ankle at the first session of intralesional application of corticosteroid. Non-depressible edema associated with hyperpigmentation reaching the lower third of the right limb, including lateral and posterior portions.
Figure 3
Figure 3
Important spacing of the collagen bundles of the upper reticular dermis, slight increase in the number of fibroblasts. Abundant deposit of mucin (arrow) (Hematoxylin & eosin, ×200) (Alcian blue, ×400).
Figure 4
Figure 4
Clinical appearance of the right foot and ankle after 11 months of intralesional corticosteroid therapy. Almost total reduction of nodules and edema, making the appearance resemble the contralateral foot.
Figure 5
Figure 5
Clinical appearance of the right foot and ankle after 11 months of treatment with intralesional corticosteroid therapy. An important reduction of nodules and cutaneous texture is observed.
See this image and copyright information in PMC

References

    1. Schwartz K.M., Fatourechi V., Ahmed D.D., Pond G.R. Dermopathy of Graves’ disease (pretibial myxedema): long-term outcome. J Clin Endocrinol Metab. 2002;87:438–446. - PubMed
    1. Lan C., Li C., Chen W., Mei X., Zhao J., Hu J. A randomized controlled trial of intralesional glucocorticoid for treating pretibial myxedema. J Clin Med Res. 2015;7:862–872. - PMC - PubMed
    1. Ramos L.O., Mattos P.C., Figueredo G.L., Maia A.A., Romero S.A. Pre-tibial myxedema: treatment with intralesional corticosteroid. An Bras Dermatol. 2015;90(Suppl. 1):143–146. - PMC - PubMed
    1. Sendhil Kumaran M., Dutta P., Sakia U., Dogra S. Long-term follow-up and epidemiological trends in patients with pretibial myxedema: an 11-year study from a tertiary care center in northern India. Int J Dermatol. 2015;54:e280–e286. - PubMed
    1. Susser W.S., Heermans A.G., Chapman M.S., Baughman R.D. Elephantiasic pretibial myxedema: a novel treatment for an uncommon disorder. J Am Acad Dermatol. 2002;46:723–726. - PubMed

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