Department of Dermatology, Silesian Medical University in Katowice, Katowice, Poland.
Acta Clin Croat. 2020 Dec;59(4):765-770. doi: 10.20471/acc.2020.59.04.26.
Thyroid gland is one of the key organs regulating the metabolism of carbohydrates, proteins and fats. Its primary function is connected with increase of the metabolic conversion of the body. Skin lesions are often one of the first symptoms of hypothyroidism. In a 71-year-old patient, skin lesions in the form of thickened areas with severe hyperkeratosis first appeared 12 years before. Eight years before, the patient was diagnosed with hypothyroidism of unknown cause. Upon admission, lesions were observed in the trunk area, left arm and vulva. These lesions had the appearance of brownish spots with hyperkeratosis. Initially, they were localized on the trunk, then involving upper limbs and neck area with time. Significant progression was present in the back area. In the anogenital area, porcelain-white discolorations were observed. Laboratory examinations were normal. During hospital stay, iv. ceftriaxone at a dose of 2.0 g/day for 10 days and intramuscular injection of vitamin B6 were administered, along with 10% urea ointment for hyperkeratosis lesions as topical therapy. The patient had lesions in the form of skin induration and discoloration, with visible, very severe hyperkeratosis, which is not characteristic of changes of the scleroderma and lichen sclerosus type. These lesions caused diagnostic problems due to the atypical clinical appearance.
甲状腺是调节碳水化合物、蛋白质和脂肪代谢的关键器官之一。它的主要功能与增加身体的代谢转换有关。皮肤损伤通常是甲状腺功能减退症的最初症状之一。在一名 71 岁的患者中,12 年前首次出现了以增厚区域和严重角化过度为特征的皮肤损伤。八年前,该患者被诊断为原因不明的甲状腺功能减退症。入院时,观察到躯干、左前臂和外阴区域存在病变。这些病变表现为角化过度的棕褐色斑点。最初,它们局限于躯干,然后随着时间的推移累及上肢和颈部区域。背部区域有明显的进展。在肛门生殖器区域,观察到瓷白色的变色。实验室检查正常。在住院期间,给予静脉注射头孢曲松 2.0 g/天,共 10 天,肌内注射维生素 B6,并局部应用 10%尿素软膏治疗角化过度病变。患者存在皮肤硬结和变色的病变,可见非常严重的角化过度,这与硬皮病和硬化性苔藓样的改变不同。这些病变由于不典型的临床表现导致诊断困难。