Graves’ Dermopathy: Responsive with Intralesion Steroid

Abstract

A 51-year-old male came with thickening lesion in both legs since 2.5 years before presented. It started with small lesion and went larger. Before diagnosed, he was admitted to hospital due to unresolved headache. He complainted nausea, easily hungry, protrusion of both eyes without diplopia or diminution of vision, tremor, palpitation, and unintentional weight loss (25-30 kgs in a year).
On examination, it was found that he was in thyrotoxic condition and has diffuse goiter. From skin examination he had raised hyperkeratotic, and waxy plaque like lesions over both pretibial region.
Laboratory examination confirm for thyrotoxic with presumably Graves’ disease with the result on Table 1. Thyroid scintigraphy showed diffused enlargement and increased uptake. Skin biopsy from the pretibial skin showed epidermis with vacuolar degeneration, partly spongiotic and hyperpigmentated, thickening basalis membrane, miksoid dermis and spreading chronic inflammatory cell in perivascular and periadneksal. It confirmed the diagnosis of myxedema hystologically.