Published online Nov 26, 2018. doi: 10.12998/wjcc.v6.i14.854
Peer-review started: August 9, 2018
First decision: August 24, 2018
Revised: September 4, 2018
Accepted: October 12, 2018
Article in press: October 11, 2018
Published online: November 26, 2018
A 53-year-old man was diagnosed with hyperthyroidism. Swollen red areas with a diameter of about 5 cm and clear boundaries and a slightly tougher texture - but without itching - were found above both ankles.
It was clearly diagnosed as pretibial myxedema (PTM).
The patient underwent blood tests at our hospital, which indicated Graves’ disease (GD).
Imaging diagnosis
The patient underwent an imaging examination at our hospital, which indicated exophthalmos and hypertrophic osteoarthropathy.
The pathological examination confirmed the diagnosis of PTM.
Intradermal injections of triamcinolone acetonide was used for PTM of the right lower extremity. A halometasone ointment was used once a day for PTM of the left lower extremity.
The skin lesions treated using radiation therapy were reported in 2014. The lesions remitting 30 d after intralesional infiltration therapy was reported in 2015. One hundred and eleven cases of PTM treated by multipoint subcutaneous injections were reported in 2016. Sendhil Kumaran et al reported the treatment of 30 cases of PTM with a glucocorticoid in 2015.
Multipoint subcutaneous injections of a long-acting glucocorticoid and the topical application of a glucocorticoid ointment are both safe and effective, with the latter being a more convenient treatment for PTM in patients with GD.