Pretibial Myxedema

Kim, Whan B.; Mistry, Nisha; Alavi, Afsáneh; Sibbald, Cathryn; Sibbald, R. Gary

doi:10.1177/1534734614531485

Cited by 7 publications

(4 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They considered that compound betamethasone with multipoint intralesional injection is a feasible, effective, and secure novel strategy in the treatment of PTM. However, we cannot evaluate the precise difference in the effects of local glucocorticoids among the different administration routes because of different clinical phenotypes, doses, and frequencies of glucocorticoid in the articles related to treatment for PTM[ 8 - 11 , 14 , 15 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Intralesional and topical glucocorticoids for pretibial myxedema: A case report and review of literature

Zhang¹,

Lin²,

Chen³

et al. 2018

WJCC

View full text Add to dashboard Cite

Pretibial myxedema (PTM), an uncommon manifestation of Graves’ disease (GD), is a local autoimmune reaction in the cutaneous tissue. The treatment of PTM is a clinical challenge. We herein report on a patient with PTM who achieved complete remission by multipoint subcutaneous injections of a long-acting glucocorticoid and topical glucocorticoid ointment application for a self-controlled study. A 53-year-old male presented with a history of GD for 3.5 years and a history of PTM for 1.5 years. Physical examination revealed slight exophthalmos, a diffusely enlarged thyroid gland, and PTM of both lower extremities. One milliliter of triamcinolone acetonide (40 mg) was mixed well with 9 mL of 2% lidocaine in a 10 mL syringe. Multipoint intralesional injections into the skin lesions of the right lower extremity were conducted with 0.5 mL of the premixed solution. A halometasone ointment was used once daily for PTM of the left lower extremity until the PTM had remitted completely. The patient’s PTM achieved complete remission in both legs after an approximately 5-mo period of therpy that included triamcinolone injections once a week for 8 wk and then once a month for 2 mo for the right lower extremity and halometasone ointment application once daily for 8 wk and then once 3-5 d for 2 mo for the left lower extremity. The total dosage of triamcinolone acetonide for the right leg was 200 mg. Our experience with this patient suggests that multipoint subcutaneous injections of a long-acting glucocorticoid and topical glucocorticoid ointment application are safe, effective, and convenient treatments. However, the topical application of a glucocorticoid ointment is a more convenient treatment for patients with PTM.

show abstract

Section: Discussionmentioning

confidence: 99%

Intralesional and topical glucocorticoids for pretibial myxedema: A case report and review of literature

Zhang¹,

Lin²,

Chen³

et al. 2018

WJCC

View full text Add to dashboard Cite

show abstract

“…It is generally considered as an autoimmune reaction dominantly caused by autoantibodies. 6 , 29 A high concentration of thyroid-stimulating hormone (TSH) receptor antibodies was found in patients with PTM. The thyrotrophin receptor located in skin lesion may be attacked by the TSH receptor antibody in the body and trigger an autoimmune damage.…”

Section: Discussionmentioning

confidence: 99%

Treatment of pretibial myxedema with intralesional immunomodulating therapy

Ren

Deng

et al. 2017

TCRM

View full text Add to dashboard Cite

ObjectiveLocal immune regulation therapy has been one of the therapeutic methods used for the treatment of autoimmune thyroid disease in patients with pretibial myxedema (PTM). However, the poor response rate and high recurrence rate are still major problems. Whether a premixed corticosteroid, compound betamethasone, could enhance remission rate and decrease recurrence rate in patients with PTM was investigated in the present study.Subjects and methodsWe have performed a clinical utility observation of compound betamethasone with intralesional injections based on basic thyroid disease treatment in 32 PTM patients between January 2008 and August 2016. The patients were followed up for 2 years, and the clinical outcomes and side effects were calculated and analyzed.ResultsAll patients had a complete remission after different times of injection. A total of 21.7% patients had complete remission with one time of injection, 34.8% with two times of injection, 17.4% with three times of injection, 4.3% with four times of injection, and 4.3% with five times of injection. In all, 56.3% patients with a disease duration of <6 months had complete remission after a 1-month treatment, 37.5% patients with a disease duration between 6 months and 12 months had complete remission after a 2-month treatment, 3.1% patients with a disease duration of 2 years had complete remission after a 5-month treatment, and 3.1% with a disease duration of 5 years had complete remission after a 7-month treatment.ConclusionCompound betamethasone with multipoint intralesional injection is a feasible, effective, and secure novel strategy in the treatment of PTM.

show abstract

“…Regarding the treatment of cosmetic issues, functional problems, or localized discomfort, local corticosteroid therapy should be used as the first step. The less severe and extensive the lesions are, the more effective the treatment is 5 . It is recommended to use adjunctive treatments such as radiotherapy, surgery, gamma globulin, intralesional steroids, and pentoxifylline.…”

Section: Introductionmentioning

confidence: 99%

“…The less severe and extensive the lesions are, the more effective the treatment is. 5 It is recommended to use adjunctive treatments such as radiotherapy, surgery, gamma globulin, intralesional steroids, and pentoxifylline. Local compressive therapy may provide additional benefits in cases of severe edema and elephantiasis.…”

Section: Introductionmentioning

confidence: 99%