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

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