Thyroid dermopathy and acropachy are 2 extrathyroidal manifestations of Graves' disease. Their presence is often associated with Graves ophthalmopathy.
Synonym: pretibial myxedema
Clinical features of thyroid dermopathy:
(1) most often affects pretibial skin but can occur at other sites (toes, face, back, shoulders, other), especially if there is recurrent pressure or trauma
(2) presents as a nonpitting edema that may show a brownish discoloration
(3) hyperkeratosis or peaud'orangemay develop
(4) may be of concern to the patient because of cosmetic appearance
(5) later stages may have a nodular or fungating appearance
(6) less often there may be skin plaques, nodules or tubular forms
(7) rarely the patient may develop elephantiasis
Clinical features of thyroid acropachy:
(1) digital clubbing
(2) swelling of the digits and toes
(3) periosteal reaction of bones in the extremities
Associated factors:
(1) cigarette smoking
(2) high titers of thyroid stimulating antibodies
