Elephantiasic Pretibial Myxedema: A Rare Manifestation in Graves’ Disease

• Main Authors: Apichat Kaewdech, Kumpol Aiempanakit, Siripan Sangmala, Kanokphorn Chiratikarnwong, Sauvarat Auepemkiate, Josef Symon S. Concha
• Format: Article
• Language: English
• Published: Prince of Songkla University 2019-05-01
• Series: Journal of Health Science and Medical Research (JHSMR)
• Subjects: dermatopathology; elephantiasis; graves’ disease; pretibial myxedema; thyroid dermopathy
• Online Access: https://www.jhsmr.org/index.php/jhsmr/article/view/42

Elephantiasic pretibial myxedema is an extremely rare condition, affecting patients with thyroid disease. The clinical manifestation is difficult to diagnosis, and the treatment is challenging. Herein, the authors report on a case of a patient with Graves’ disease, who had a long-standing enlargement of bilateral legs, and histopathologic studies confirmed the diagnosis as; pretibial myxedema. The patient was treated with an antithyroid drug, iodine-131 (131I) irradiation, a potent topical corticosteroid, with occlusion, and compression therapy, however, the patient’s skin condition remained unchanged. This report aims to demonstrate a rare form of pretibial myxedema, to review the clinical presentations, differential diagnosis as well as therapeutic options.