Myxedema
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Myxedema is a skin and tissue disorder usually due to hypothyroidism. It can also be caused by goiter, Hashimoto's thyroiditis, Thyroid surgery, and Graves' disease (which rarely causes myxedema of knee and shin called pretibial myxedema)
Symptoms
Myxedema usually presents itself with some of the following symptoms:
- Skin thickening
- Coarse skin
- Change in facial appearance
- Thickening nose
- Swollen lips
- Puffiness around the eyes
- Jelly-like infiltrations in subcutaneous tissues
- Slow speech
- Mental dullness
- Lethargy
- Mental problems
- Dry skin
- Yellow skin
- Swollen subcutaneous tissue
- Weight gain
- Constipation
- Thinning hair
- Brittle hair
- Bald patches
- Muscle pains
- Deafness
- Hearing impairment
- Carpal tunnel syndrome
Causes
Myxedema stemming from both hyperthyroid and hypothyroid conditions, results from the accumulation of increased amounts of hyaluronic acid and chondroitin sulfate in the dermis in both lesional and normal skin. The mechanism that causes myxedema is still not yet understood, although animal model studies suggest that thyroid hormones affect the synthesis and catabolism of mucopolysaccharides and collagen by dermal fibroblasts. The fibroblasts in the orbital and pretibial dermis share antigenic sites that underlie the autoimmune process that causes Grave's disease. This cross-reaction may contribute to the development of myxedema occurring long after euthyroid status is achieved through treatment.Treatment
Treatment for myxedema is difficult. Systemic or intralesional glucocorticoids, topical glucocorticoids under occlusion or high-dose intravenous immunoglobulin have been reported to offer some relief to patients Treatment should follow correction of the original hyperthyroidism/hypothyroidism.External links
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