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Pretibial myxedema mimicking elephantiasis
Pinaki Dutta1, Viral N Shah2
1DM, Assistant Professor, Department of Endocrinology, 4th Floor, F Block, Nehru Hospital, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.
2DM, Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.

doi:10.5348/ijcri-2013-12-413-CR-7

Address correspondence to:
Dr. Pinaki Dutta
DM, Assistant Professor, Department of Endocrinology
4th Floor, F Block, Nehru Hospital, Post Graduate Institute of Medical Education and Research
Sector 12, Chandigarh
India - 160012
Phone: +91-172-2756584; +91-935711477
Fax: +91-0172-2747944
Email: pinaki_dutta@hotmail.com

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How to cite this article:
Dutta P, Shah VN. Pretibial myxedema mimicking elephantiasis. International Journal of Case Reports and Images 2013;4(12):695–697.


Abstract
Introduction: Elephantiasic pretibial myxedema is a rare manifestation of autoimmune thyroid disease. Herein, we report a case of elephantiasic pretibial myxedema.
Case Report: A 45-year-old male presented with bilateral firm confluent pretibial polypoid hyperpigmented nodular and plaque lesions. He had a history of thyroidectomy for toxic goitre in the past and was not on any thyroxine replacement therapy. On examination, he had dry skin, myxedematous appearance and grade 3 clubbing of fingers. Investigations revealed elevated thyroid stimulating hormone and thyroid stimulating hormone receptor stimulating antibody levels. Histopathology of the skin lesion was suggestive of pretibial myxedema. The patient was started with thyroxine replacement and steroid occlusive dressing over lesions. His condition was improved remarkably with treatment.
Conclusion: Elephantiasic pretibial myxedema is rare. This condition should be recognized promptly and should be treated with steroid, occlusive dressing and treatment of underlying thyroid disease.

Keywords: Pretibial myxedema, Graves’ disease, Thyroid stimulating hormone receptor antibody, Hypothyroidism


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Author Contributions
Pinaki Dutta – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Viral N Shah – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© Pinaki Dutta et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)