Pretibial Myxedema Treatment & Management

1. Doshi DN, Blyumin ML, Kimball AB. Cutaneous manifestations of thyroid disease. Clin Dermatol. 2008 May-Jun. 26(3):283-7. [Medline].

2. Nair PA, Mishra A, Chaudhary A. Pretibial myxedema associated with euthyroid Hashimoto's thyroiditis: a case report. J Clin Diagn Res. 2014 Jun. 8(6):YD01-2. [Medline]. [Full Text].

3. Verma S, Rongioletti F, Braun-Falco M, Ruzicka T. Preradial myxedema in a euthyroid male: A distinct rarity. Dermatol Online J. 2013 Apr 15. 19(4):9. [Medline]. [Full Text].

4. Schwartz KM, Fatourechi V, Ahmed DD, Pond GR. Dermopathy of Graves' disease (pretibial myxedema): long-term outcome. J Clin Endocrinol Metab. 2002 Feb. 87(2):438-46. [Medline].

5. Kamath C, Young S, Kabelis K, et al. Thyrotrophin receptor antibody characteristics in a woman with long-standing Hashimoto's who developed Graves' disease and pretibial myxoedema. Clin Endocrinol (Oxf). 2012 Sep. 77(3):465-70. [Medline].

6. Komosinska-Vassev K, Winsz-Szczotka K, Olczyk K, Kozma EM. Alterations in serum glycosaminoglycan profiles in Graves' patients. Clin Chem Lab Med. 2006. 44(5):582-8. [Medline].

7. Heufelder AE, Bahn RS, Scriba PC. Analysis of T-cell antigen receptor variable region gene usage in patients with thyroid-related pretibial dermopathy. J Invest Dermatol. 1995 Sep. 105(3):372-8. [Medline].

8. Kraus CN, Sodha P, Vaidyanathan P, Kirkorian AY. Thyroid dermopathy and acropachy in pediatric patients. Pediatr Dermatol. 2018 Nov. 35(6):e371-e374. [Medline].

9. Lan C, Chen W, Zhao J, Li C, Mei X, Hu J. Prevalence and clinical characteristics of pretibial myxedema in Chinese outpatients with thyroid diseases. J Endocrinol Metab. 2015. 5(4):250-5. [Full Text].

10. Lohiya S, Lohiya V, Stahl EJ. Pretibial myxedema without ophthalmopathy: an initial presentation of Graves' disease. Am J Med Sci. 2013 Jul. 346(1):73-5. [Medline].

11. Sendhil Kumaran M, Dutta P, Sakia U, Dogra S. Long-term follow-up and epidemiological trends in patients with pretibial myxedema: an 11-year study from a tertiary care center in northern India. Int J Dermatol. 2015 Aug. 54(8):e280-6. [Medline].

12. Fatourechi V, Bartley GB, Eghbali-Fatourechi GZ, Powell CC, Ahmed DD, Garrity JA. Graves' dermopathy and acropachy are markers of severe Graves' ophthalmopathy. Thyroid. 2003 Dec. 13(12):1141-4. [Medline].

13. Missner SC, Ramsay EW, Houck HE, Kauffman CL. Graves' disease presenting as localized myxedema in a thigh donor graft site. J Am Acad Dermatol. 1998 Nov. 39(5 Pt 2):846-9. [Medline].

14. Ferreli C, Pinna AL, Pilloni L, Corbeddu M, Rongioletti F. Obesity-associated lymphedematous mucinosis: two further cases and review of the literature. Dermatopathology (Basel). 2018 Jan-Mar. 5(1):16-20. [Medline]. [Full Text].

15. Ai J, Leonhardt JM, Heymann WR. Autoimmune thyroid diseases: etiology, pathogenesis, and dermatologic manifestations. J Am Acad Dermatol. 2003 May. 48(5):641-59; quiz 660-2. [Medline].

16. Xu Y, Ma R, Cai Y, Zheng X. Response to topical halcinonide following fractional carbon dioxide laser pretreatment in a pretibial myxedema patient. Indian J Dermatol Venereol Leprol. 2018 Nov-Dec. 84(6):763. [Medline].

17. Lan C, Li C, Chen W, Mei X, Zhao J, Hu J. A randomized controlled trial of intralesional glucocorticoid for treating pretibial myxedema. J Clin Med Res. 2015 Nov. 7(11):862-72. [Medline]. [Full Text].

18. Ramos LO, Mattos PC, Figueredo GL, Maia AA, Romero SA. Pre-tibial myxedema: treatment with intralesional corticosteroid. An Bras Dermatol. 2015 Jun. 90(3 Suppl 1):143-6. [Medline].

19. Ren Z, He M, Deng F, et al. Treatment of pretibial myxedema with intralesional immunomodulating therapy. Ther Clin Risk Manag. 2017. 13:1189-94. [Medline]. [Full Text].

20. Ferreira M, Zacaron LH, Valle AFD, Gamonal ACC. Successful therapeutic approach in a patient with elephantiasic pretibial myxedema. An Bras Dermatol. 2020 Jul - Aug. 95(4):469-72. [Medline]. [Full Text].

21. Pineda AM, Tianco EA, Tan JB, Casintahan FA, Beloso MB. Oral pentoxifylline and topical clobetasol propionate ointment in the treatment of pretibial myxoedema, with concomitant improvement of Graves' ophthalmopathy. J Eur Acad Dermatol Venereol. 2007 Nov. 21(10):1441-3. [Medline].

22. Turke B, Balazs C. [Treatment of pretibial myxoedema with pentoxifylline]. Orv Hetil. 2012 Oct 28. 153(43):1719-22. [Medline].

23. Engin B, Gumusel M, Ozdemir M, Cakir M. Successful combined pentoxifylline and intralesional triamcinolone acetonide treatment of severe pretibial myxedema. Dermatol Online J. 2007 May 1. 13(2):16. [Medline].

24. Antonelli A, Navarranne A, Palla R, e al. Pretibial myxedema and high-dose intravenous immunoglobulin treatment. Thyroid. 1994 Winter. 4(4):399-408. [Medline].

25. Priestley GC, Aldridge RD, Sime PJ, Wilson D. Skin fibroblast activity in pretibial myxoedema and the effect of octreotide (Sandostatin) in vitro. Br J Dermatol. 1994 Jul. 131(1):52-6. [Medline].

26. Shinohara M, Hamasaki Y, Katayama I. Refractory pretibial myxoedema with response to intralesional insulin-like growth factor 1 antagonist (octreotide): downregulation of hyaluronic acid production by the lesional fibroblasts. Br J Dermatol. 2000 Nov. 143(5):1083-6. [Medline].

27. Rotman-Pikielny P, Brucker-Davis F, Turner ML, Sarlis NJ, Skarulis MC. Lack of effect of long-term octreotide therapy in severe thyroid-associated dermopathy. Thyroid. 2003 May. 13(5):465-70. [Medline].

28. Felton J, Derrick EK, Price ML. Successful combined surgical and octreotide treatment of severe pretibial myxoedema reviewed after 9 years. Br J Dermatol. 2003 Apr. 148(4):825-6. [Medline].

29. Deng A, Song D. Multipoint subcutaneous injection of long-acting glucocorticid as a cure for pretibial myxedema. Thyroid. 2011 Jan. 21(1):83-5. [Medline].

30. Takasu N, Higa H, Kinjou Y. Treatment of pretibial myxedema (PTM) with topical steroid ointment application with sealing cover (steroid occlusive dressing technique: steroid ODT) in Graves' patients. Intern Med. 2010. 49(7):665-9. [Medline].

31. Couto JA, Schmidt BA, Greene AK. Nodular foot myxedema masquerading as lymphedema. Plast Reconstr Surg Glob Open. 2015 Jul. 3(7):e457. [Medline]. [Full Text].

32. Rodia C, Menconi F, Mazoni L, et al. A case of unilateral dermopathy possibly related to Graves' disease. Eur Thyroid J. 2019 Oct. 8(5):278-82. [Medline]. [Full Text].

Ranjodh Singh Gill, MD, FACP, CCD Associate Professor of Medicine, Division of Endocrinology, Virginia Commonwealth University School of Medicine and McGuire Veterans Administration Medical Center; Consulting Staff, Department of Internal Medicine, Virginia Commonwealth University Health System

Ranjodh Singh Gill, MD, FACP, CCD is a member of the following medical societies: American Association of Physicians of Indian Origin, American College of Physicians, Endocrine Society, International Society for Clinical Densitometry, Medical Society of Virginia, North American Sikh Medical and Dental Association, Richmond Academy of Medicine

Disclosure: Nothing to disclose.

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society for MOHS Surgery, Association of Military Dermatologists, Phi Beta Kappa

Disclosure: Nothing to disclose.

Christen M Mowad, MD Professor, Department of Dermatology, Geisinger Medical Center

Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, Noah Worcester Dermatological Society, Pennsylvania Academy of Dermatology, American Academy of Dermatology, Phi Beta Kappa

Disclosure: Nothing to disclose.

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Kathryn K Garner, MD Staff Physician, Family Health Clinic, Ehrling Bergquist Clinic, Offutt AFB, NE

Kathryn K Garner, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Physicians, Uniformed Services Academy of Family Physicians

Disclosure: Nothing to disclose.

Purnima Sau, MD Associate Professor, Department of Clinical Dermatology, Uniformed Services University of the Health Sciences

Disclosure: Nothing to disclose.

Laurel R Stearns, DO ResidentPhysician, Department of Dermatology, National Capital Consortium

Laurel R Stearns, DO is a member of the following medical societies: American Academy of Dermatology and Association of Military Osteopathic Physicians and Surgeons

Disclosure: Nothing to disclose.

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