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Arch Dermatol. 2009;145(9):1053-1058.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Localized myxedema involving posttibial skin.

MICROSCOPIC FINDINGS AND CLINICAL COURSE

The lesional biopsy specimen demonstrated an effaced epidermis with prominent vasculature and few adnexal structures. Dermal elements were widely spaced with a blue granular substance between collagen bundles. There was little inflammation. The Alcian blue stain confirmed the presence of increased dermal mucin (Figure 3), which was digestible with hyaluronidase (data not shown). The patient was treated with flurandrenolide tape and compression stockings with little improvement. Over time, the plaques expanded to involve the classic pretibial area.

Figure appears in full text version. Figure 3.

DISCUSSION

Localized myxedema usually occurs with Graves ophthalmopathy.¹ Other classic features of Graves disease include thyroid acropathy (digital clubbing), goiter, and the presence of thyroid-stimulating hormone (TSH) receptor antibodies. Graves disease is 7 times more common in women than in men. Localized myxedema may develop years after correction of hyperthyroidism, may be worsened transiently by thyroid ablation,² and may resolve when thyroid antibodies disappear. It rarely occurs in patients with . . . [Full Text of this Article]

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Arch Dermatol. 2009;145(9):1053-1058.
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