Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 First ST SW, Rochester, MN, USA.
Best Pract Res Clin Endocrinol Metab. 2012 Aug;26(4):553-65. doi: 10.1016/j.beem.2011.10.001. Epub 2012 May 22.
Graves' disease is an autoimmune condition commonly associated with thyroid dysfunction and with anti-thyroid antibodies, usually TSH receptor stimulating antibodies. Thyroid autoimmunity also may be associated with extra thyroidal manifestations. Most common extra thyroidal manifestation is ophthalmopathy. Less common is thyroid dermopathy, usually occurring in pretibial area. Dermopathy is almost always associated with ophthalmopathy and in severe cases with acropachy. A common antigen with thyroid in tissues of the skin and the eyes, most likely TSH receptor, is involved in pathogenesis of extra thyroidal manifestations. Presence of dermopathy and acropachy are predictors of severity of autoimmune process. Local corticosteroid application is the standard therapy for dermopathy. Response to therapy is good in mild cases and poor in severe cases. Immune modulators and biotherapies are undergoing randomized trials for ophthalmopathy component of Graves' disease. Any therapy proven to be effective for ophthalmopathy can be utilized in future for management of dermopathy.
格雷夫斯病是一种自身免疫性疾病，通常与甲状腺功能障碍和抗甲状腺抗体有关，通常是 TSH 受体刺激性抗体。甲状腺自身免疫也可能与甲状腺外表现有关。最常见的甲状腺外表现是眼病。不太常见的是甲状腺皮肤病，通常发生在前胫区域。皮肤病几乎总是与眼病有关，在严重的情况下与肢端肥大症有关。皮肤和眼睛组织中与甲状腺有共同抗原的物质，很可能是 TSH 受体，参与了甲状腺外表现的发病机制。皮肤病和肢端肥大症的存在是自身免疫过程严重程度的预测指标。局部皮质类固醇应用是皮肤病的标准治疗方法。轻度病例的治疗反应良好，重度病例的治疗反应不佳。免疫调节剂和生物疗法正在进行格雷夫斯病眼病成分的随机试验。任何被证明对眼病有效的治疗方法都可以在未来用于皮肤病的治疗。
