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Articles

Title: A case of pretibial myxedema - the diagnostics and the treatment problems.

Author:
Agnieszka Sebastian-Rusin, Małgorzata Tupikowska, Grażyna Bednarek-Tupikowska, Joanna Maj, Eugeniusz Baran
Type:
Case Reports
Language:
PL
Journal:
Clinical Dermatology
Year:
2009
Volume:
11
Number:
3
Start page:
155
Final page:
158
ISSN:
1730-7201
Keywords:
Graves' disease, dermopathy, myxedema
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Pretibial myxedema is an infrequent dermatopathy, that occurs in some patients with Graves' disease. It rarely coexist with thyroid ophtalmopathy or acropachy, the other manifestations of this autoimmunological disease. We present a case of a 76-year-old woman with Graves' disease who was first treated with thyreostatics and then, because of the recurrent thyreotoxicosis she was given a radical therapy with radioactive iodine. Two years later a nonpitting edema accompanied by typical skin color changes and hipertrichosis localized on her feet and in the pretibial area appeared. Our patient didn't realize that it could be a new manifestation of Graves' disease. Many dermatological diseases were considered in the differential diagnosis. Because of the dermatological and ophtalmological complaints both local and systemic steroids were given by the endocrinologist and a complete remission was achieved. The dose of steroids was gradually reduced. About three weeks after the therapy was finished, the symptoms' recurrence was observed. The therapy with steroids was repeated and the second remission was achieved. The patient stays under the clinical control. We present this case because of the rare incidence of the pretibial myxedema, the diagnostic problems and treatment difficulties that it caused to many specialists.