Pretibial myxedema mimicking elephantiasis

Pinaki Dutta,Viral N Shah

doi:10.5348/ijcri-2013-12-413-cr-7

Abstract

Elephantiasic pretibial myxedema is a rare manifestation of autoimmune thyroid disease. Herein, we report a case of elephantiasic pretibial myxedema. A 45-year-old male presented with bilateral firm confluent pretibial polypoid hyperpigmented nodular and plaque lesions. He had a history of thyroidectomy for toxic goitre in the past and was not on any thyroxine replacement therapy. On examination, he had dry skin, myxedematous appearance and grade 3 clubbing of fingers. Investigations revealed elevated thyroid stimulating hormone and thyroid stimulating hormone receptor stimulating antibody levels. Histopathology of the skin lesion was suggestive of pretibial myxedema. The patient was started with thyroxine replacement and steroid occlusive dressing over lesions. His condition was improved remarkably with treatment. Elephantiasic pretibial myxedema is rare. This condition should be recognized promptly and should be treated with steroid, occlusive dressing and treatment of underlying thyroid disease.

Highlights

Elephantiasic pretibial myxedema is a rare manifestation of autoimmune thyroid disease
Pretibial myxedema (PTM) is an immune mediated localized form of thyroid associated dermopathy often found in patients with autoimmune thyroid disease, Graves’ diseases [1]
Elephantiasis form of (PTM) which is known as elephantiasis nostra verrucosa (ENV) is extreme rare form which is found late in the course of Graves’ disease [3]

Summary

Introduction

Elephantiasic pretibial myxedema is a rare manifestation of autoimmune thyroid disease. Received: 08 February 2013 Accepted: 27 April 2013 Published: 01 December 2013 occlusive dressing and treatment of underlying thyroid disease. Pretibial myxedema (PTM) is an immune mediated localized form of thyroid associated dermopathy often found in patients with autoimmune thyroid disease, Graves’ diseases [1]. We describe a case who remained hypothyroid for a long period of time, eventually developed elephantiasic PTM.

Results

Conclusion