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Review

Thyroid dermopathy and acropachy

Pages 75-90 | Published online: 10 Jan 2014
 

Abstract

Graves’ disease is an autoimmune condition with extrathyroidal immune-mediated manifestations, including ophthalmopathy and dermopathy. Dermopathy, or pretibial myxedema, typically occurs in patients with ophthalmopathy. The presence of high levels of thyrotropin receptor antibodies indicates a more severe autoimmune process. Diagnosis is on recognition of clinical features; skin biopsy may be needed in some cases. One in four patients with thyroid dermopathy, usually occurring in the pretibial area, has acropachy and digital clubbing. Localization to the pretibial area is most likely due to dependency and mechanical factors. Rarely, upper body involvement occurs, usually triggered by trauma. Mild cases resolve over time. Moderate or severe cases require local corticosteroid therapy. Severe cases, including elephantiasis, are usually persistent and mimic lymphedema.

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

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