Verma Shyam, Rongioletti Franco, Braun-Falco Markus, Ruzicka Thomas
Nirvana Skin Clinic, Vadodara, Gujarat, India.
Dermatol Online J. 2013 Apr 15;19(4):9.
Localized or pretibial myxedema is one of the signs of Graves disease (along with goiter, exophthalmus, thyroid acropathy, and high circulating levels of long-acting thyroid-stimulating hormone) and usually tends to occur at a later stage of the disease or even after the patient becomes euthyroid post treatment. Very rarely has it been reported in euthyroid patients. We report a euthyroid man presenting with localized myxedema on the extensor surface of his forearm with clinical and histopathological features consistent with pretibial myxedema. He responded partially to topical clobetasol propionate cream and tacrolimus ointment 0.1 percent for about 7 months. To the best of our knowledge, this is the first case of preradial myxedema in a euthyroid patient in the English international dermatological literature.
局限性或胫前黏液性水肿是格雷夫斯病的体征之一(与甲状腺肿、突眼、甲状腺性肢端病以及长效甲状腺刺激素的高循环水平一同出现),通常倾向于在疾病的后期出现,甚至在患者治疗后甲状腺功能恢复正常之后出现。在甲状腺功能正常的患者中很少有相关报道。我们报告一例甲状腺功能正常的男性,其前臂伸侧出现局限性黏液性水肿,临床和组织病理学特征与胫前黏液性水肿一致。他局部外用丙酸氯倍他索乳膏和0.1%他克莫司软膏治疗约7个月后有部分反应。据我们所知,这是英文国际皮肤病学文献中首例甲状腺功能正常患者出现桡前黏液性水肿的病例。