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Pretibial Myxedema Information

Pretibial Myxedema is an infiltrative dermopathy, resulting as a rare complication of Grave's disease, with an incidence rate of about 1-4% in patients. Pretibial myxedema occurs as a result of the deposition of hyaluronic acid in the dermis and subcutis. The precise cause of this phenomenon remains uncertain. It is characterized by thickening of a layer of tissue that lies directly beneath the surface of skin called the dermis. The condition mostly occurs in older people. It usually presents itself as a non-localised, non-pitting edema and thickening of the skin which usually occurs on the anterior aspect of the lower legs spreading to the dorsum of the feet. Almost all cases of pretibial myxedema are associated with relatively severe ophthalmopathy. Usually ophthalmopathy appears first and dermopathy much later. All patients with pretibial myxedema have high serum concentrations of thyroid-stimulating hormone receptor antibodies, indicating the severity of the autoimmune condition. Pretibial myxedema usually becomes evident when raised lesions begin to appear on the skin that covers the front surfaces of the shins. These lesions are usually light in color, though they may darken over time. In rare cases, lesions may grow to the point where they block the flow of fluid through the lymphatic vessels. This may lead to severe swelling of the limbs. While the underlying cause of pretibial myxedema is not completely understood, it has been suggested that it may represent an autoimmune disorder. In mild cases that do not require treatment, 50% of patients achieve complete remission after several years. Severe cases that receive topical corticosteroids or other therapies do not have a better outcome than untreated milder cases.

Causes of Pretibial Myxedema

The common causes and risk factor's of Pretibial Myxedema include the following:

  • The exect cause of pretibial myxedema is unknown.
  • Graves' disease.

Symptoms of Pretibial Myxedema

Some sign and symptoms related to Pretibial Myxedema are as follows:

  • Weight gain.
  • Cold intolerance.
  • Depression.
  • Fatigue.
  • Joint or muscle pain.
  • Paleness.
  • Thin, brittle fingernails.

Treatment of Pretibial Myxedema

Here is list of the methods for treating Pretibial Myxedema :

  • Topical cream or low dose oral predisone.
  • Local application of corticosteroids remains the mainstay of treatment.
  • Compression wraps or stockings that provide 20-40 mm Hg of pressure can be useful as an adjunctive therapy.


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