Pretibial myxedema successfully treated with intralesional hyaluronidase

Hoesly, Paul M.; Tolaymat, Leila; Sluzevich, Jason C.; Keeling, James H.

doi:10.1016/j.jdcr.2018.08.018

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Cited by 14 publications

(9 citation statements)

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“… 9 Alternative therapies for PTM with variable efficacy have been reported, including pentoxifylline, octreotide, plasmapheresis, radiotherapy, excision, and intralesional hyaluronidase. 1 , 10 …”

Section: Discussionmentioning

confidence: 99%

An atypical presentation of pretibial myxedema in a euthyroid patient with absent antithyroid autoantibodies

Beaulieu¹,

Nord²

2021

JAAD Case Reports

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Section: Discussionmentioning

confidence: 99%

An atypical presentation of pretibial myxedema in a euthyroid patient with absent antithyroid autoantibodies

Beaulieu¹,

Nord²

2021

JAAD Case Reports

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“…The treatment of choice is topical application of a mid- or high-strength glucocorticoid under occlusion to improve absorption [ 7 , 8 , 9 ]. Pentoxifylline [ 10 , 11 ], intralesional injections of hyaluronidase with [ 12 ] or without [ 13 , 14 ] intralesional injections of glucocorticoid, rituximab [ 15 ], IVIG [ 16 ] and UVA-1 phototherapy [ 17 ] have all been reported with varying degrees of success.…”

Section: Discussionmentioning

confidence: 99%

Insidious-Onset Indurated Plaques on the Shins

2021

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A 64-year old male presented with a several-year history of an insidious-onset tender, itchy and xerotic rash on his lower legs. Past medical history was significant for Graves’ disease and Graves’ ophthalmopathy. The examination revealed peau d’orange-appearing plaques on his shins clinically consistent with pretibial myxedema. A punch biopsy showed separation of collagen bundles with extensive dermal mucin deposition, confirming the diagnosis of pretibial myxedema. After initially failing treatment with a topical clobetasol 0.05% ointment, the patient switched to regular pentoxifylline and triamcinolone 0.1% ointment under occlusion. He remains under follow-up.

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“…One week later, only the area treated with hyaluronidase injections was cleared [15]. Recently, Hoesly et al [16] have also reported its efficacy in 2 patients. All these case reports suggest a very good efficacy of injected hyaluronidase for the treatment of localized myxedema.…”

Section: Discussionmentioning

confidence: 99%