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.
Author: Tri Juli E Tarigan,
Rahadi Rihatmadja, Erna Hutabarat
Journal Code: jpkedokterangg140316
