Key result
Treatment with thyroxine replacement and topical steroid occlusive dressing led to remarkable clinical improvement and modest decrease in nodular pretibial myxedema in a patient with severe hypothyroidism.
Case Report (n=1)
Elephantiasic pretibial myxedema is a rare manifestation of autoimmune thyroid disease that can be effectively treated with thyroxine replacement and steroid occlusive dressings.
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May support thyroxine-steroid dressings for pretibial myxedema; hypothesis-generating and needs controlled trials.
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.
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Dutta et al. (2013) conducted a case report in Elephantiasic pretibial myxedema (n=1). Thyroxine replacement and steroid occlusive dressing was evaluated on Clinical improvement of symptoms and skin lesions. Treatment with thyroxine replacement and topical steroid occlusive dressing led to remarkable clinical improvement and modest decrease in nodular pretibial myxedema in a patient with severe hypothyroidism.
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