Pretibial Myxedema, Nodular Variant: Unique Presentation and Clinical Course

Authors

Rand Abou Shaar, Henry Ford HealthFollow
Sheeren Zia, Henry Ford HealthFollow
Mohamed Alhamar, Henry Ford HealthFollow
Adrian Ormsby, Henry Ford HealthFollow

Recommended Citation

Abou Shaar R, Zia S, Alhamar M, Ormsby A. Pretibial Myxedema, Nodular Variant: Unique Presentation and Clinical Course. JOJ Dermatol & Cosmet 2020; 2(4):555591.

Document Type

Article

Publication Date

4-3-2020

Publication Title

JOJ Dermatol & Cosmet

Abstract

Literature has shown morphological diversity in the presentation and occurrence of pretibial myxedema following I-131 treatment. We present a case of a 47 y.o African American male with post I-131 hypothyroidism for Graves disease that presented with enlarging bilateral lower extremity and ankle lesions. Examination revealed firm, tender, hemispherical, large, hyperpigmented nodules. Ultrasound demonstrated nonspecific hypovascular nodular thickening of the skin. Excisional biopsy showed reactive dermal and subcutaneous fibrosis with dermal mucinosis. Alcian blue stain confirmed the diagnosis. Graves’ dermopathy is generally rare, with the nodular variant accounting for 10% of cases. Our case reflects a variable appearance of post-I-131 treatment dermopathy partially resistant to the multimodal treatment.

PubMed ID

Not assigned.

Volume

2

Issue

4

First Page

555591