Graves' disease presenting as elephantiasic pretibial myxedema and nodules of the hands
Identifieur interne : 000D35 ( Istex/Corpus ); précédent : 000D34; suivant : 000D36Graves' disease presenting as elephantiasic pretibial myxedema and nodules of the hands
Auteurs : Soyun Cho ; Jee-Ho Choi ; Kyung-Jeh Sung ; Kee-Chan Moon ; Jai-Kyoung KohSource :
- International Journal of Dermatology [ 0011-9059 ] ; 2001-04.
Abstract
A 67‐year‐old man presented with a 2‐year history of asymptomatic, firm, multiple nodules and plaques and cerebriform hypertrophy of both lower legs and feet, and well‐defined, skin‐colored, firm nodules and tumors on both hands. He had been diagnosed as having Graves' disease 3 years previously, and had been treated with 10 mg of methimazole and 100 μg of thyroxin (T4) daily for 2 years. Physical examination revealed nonpitting edema, flesh‐colored to erythematous, firm, confluent, polypoid nodules and fissured plaques extending from the shins to the dorsa of both feet (Fig. 1), and round to oval, firm, skin‐colored, walnut‐to‐egg‐sized tumors on all 10 fingers and the ulnar side of the dorsum of the right hand (Fig. 2). The thyroid gland was diffusely enlarged; however, there was no exophthalmos, and extraocular movements were normal. There was no weight loss, loss of appetite, tremor, heat intolerance, diarrhea, or fatigue. On laboratory evaluation, thyroid‐stimulating hormone (TSH) had a markedly low titer of < 0.05 μU/mL (normal: 0.4–5.0), and the TSH receptor antibody was extremely high at 73.8% (normal: < 15%). Serum free triiodothyronine (T3), T4, antimicrosome, and antithyroglobulin antibodies were normal or negative. Skin biopsy samples from the shin and hand disclosed extensive mucin deposition throughout the dermis. Confluent, firm nodules and plaques on both shins and the dorsa of both feet Firm, nonpitting, well‐circumscribed, flesh‐colored masses with orange‐peel appearance of overlying skin and growth of coarse hair on the dorsum of the right hand
Url:
DOI: 10.1046/j.1365-4362.2001.01108.x
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ISTEX:1C8DF41186D35F4A81936D55476A4FCC579F99B8Le document en format XML
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Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</mods:affiliation></affiliation></author><author><name sortKey="Moon, Kee Han" sort="Moon, Kee Han" uniqKey="Moon K" first="Kee-Chan" last="Moon">Kee-Chan Moon</name><affiliation><mods:affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</mods:affiliation></affiliation></author><author><name sortKey="Koh, Jai Young" sort="Koh, Jai Young" uniqKey="Koh J" first="Jai-Kyoung" last="Koh">Jai-Kyoung Koh</name><affiliation><mods:affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:1C8DF41186D35F4A81936D55476A4FCC579F99B8</idno><date when="2001" year="2001">2001</date><idno type="doi">10.1046/j.1365-4362.2001.01108.x</idno><idno 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Korea</mods:affiliation></affiliation></author><author><name sortKey="Sung, Kyung Eh" sort="Sung, Kyung Eh" uniqKey="Sung K" first="Kyung-Jeh" last="Sung">Kyung-Jeh Sung</name><affiliation><mods:affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</mods:affiliation></affiliation></author><author><name sortKey="Moon, Kee Han" sort="Moon, Kee Han" uniqKey="Moon K" first="Kee-Chan" last="Moon">Kee-Chan Moon</name><affiliation><mods:affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</mods:affiliation></affiliation></author><author><name sortKey="Koh, Jai Young" sort="Koh, Jai Young" uniqKey="Koh J" first="Jai-Kyoung" last="Koh">Jai-Kyoung Koh</name><affiliation><mods:affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South 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and cerebriform hypertrophy of both lower legs and feet, and well‐defined, skin‐colored, firm nodules and tumors on both hands. He had been diagnosed as having Graves' disease 3 years previously, and had been treated with 10 mg of methimazole and 100 μg of thyroxin (T4) daily for 2 years. Physical examination revealed nonpitting edema, flesh‐colored to erythematous, firm, confluent, polypoid nodules and fissured plaques extending from the shins to the dorsa of both feet (Fig. 1), and round to oval, firm, skin‐colored, walnut‐to‐egg‐sized tumors on all 10 fingers and the ulnar side of the dorsum of the right hand (Fig. 2). The thyroid gland was diffusely enlarged; however, there was no exophthalmos, and extraocular movements were normal. There was no weight loss, loss of appetite, tremor, heat intolerance, diarrhea, or fatigue. On laboratory evaluation, thyroid‐stimulating hormone (TSH) had a markedly low titer of < 0.05 μU/mL (normal: 0.4–5.0), and the TSH receptor antibody was extremely high at 73.8% (normal: < 15%). Serum free triiodothyronine (T3), T4, antimicrosome, and antithyroglobulin antibodies were normal or negative. Skin biopsy samples from the shin and hand disclosed extensive mucin deposition throughout the dermis. Confluent, firm nodules and plaques on both shins and the dorsa of both feet Firm, nonpitting, well‐circumscribed, flesh‐colored masses with orange‐peel appearance of overlying skin and growth of coarse hair on the dorsum of the right hand</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>myxedema</json:string><json:string>nodule</json:string><json:string>pretibial</json:string><json:string>pretibial myxedema</json:string><json:string>dorsum</json:string><json:string>dermatology</json:string><json:string>elephantiasic</json:string><json:string>nonpitting</json:string><json:string>ophthalmopathy</json:string><json:string>polypoid</json:string><json:string>localized myxedema</json:string><json:string>ngers</json:string><json:string>right hand</json:string><json:string>asan</json:string><json:string>ulsan</json:string><json:string>dermopathy</json:string><json:string>soyun</json:string><json:string>elephantiasic form</json:string><json:string>blackwell 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He had been diagnosed as having Graves' disease 3 years previously, and had been treated with 10 mg of methimazole and 100 μg of thyroxin (T4) daily for 2 years. Physical examination revealed nonpitting edema, flesh‐colored to erythematous, firm, confluent, polypoid nodules and fissured plaques extending from the shins to the dorsa of both feet (Fig. 1), and round to oval, firm, skin‐colored, walnut‐to‐egg‐sized tumors on all 10 fingers and the ulnar side of the dorsum of the right hand (Fig. 2). The thyroid gland was diffusely enlarged; however, there was no exophthalmos, and extraocular movements were normal. There was no weight loss, loss of appetite, tremor, heat intolerance, diarrhea, or fatigue. On laboratory evaluation, thyroid‐stimulating hormone (TSH) had a markedly low titer of > 0.05 μU/mL (normal: 0.4–5.0), and the TSH receptor antibody was extremely high at 73.8% (normal: > 15%). Serum free triiodothyronine (T3), T4, antimicrosome, and antithyroglobulin antibodies were normal or negative. Skin biopsy samples from the shin and hand disclosed extensive mucin deposition throughout the dermis. 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Korea</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Jee‐Ho</forename><surname>Choi</surname><roleName type="degree">MD</roleName></persName><affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Kyung‐Jeh</forename><surname>Sung</surname><roleName type="degree">MD</roleName></persName><affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Kee‐Chan</forename><surname>Moon</surname><roleName type="degree">MD and</roleName></persName><affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Jai‐Kyoung</forename><surname>Koh</surname><roleName type="degree">MD</roleName></persName><affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</affiliation></author><idno type="istex">1C8DF41186D35F4A81936D55476A4FCC579F99B8</idno><idno type="DOI">10.1046/j.1365-4362.2001.01108.x</idno><idno type="unit">IJD1108</idno><idno type="toTypesetVersion">file:IJD.IJD1108.pdf</idno></analytic><monogr><title level="j" type="main">International Journal of Dermatology</title><title level="j" type="alt">INTERNATIONAL JOURNAL OF DERMATOLOGY</title><idno type="pISSN">0011-9059</idno><idno type="eISSN">1365-4632</idno><idno type="book-DOI">10.1111/(ISSN)1365-4632</idno><idno type="book-part-DOI">10.1111/ijd.2001.40.issue-4</idno><idno type="product">IJD</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">40</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" 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He had been diagnosed as having Graves' disease 3 years previously, and had been treated with 10 mg of methimazole and 100 μg of thyroxin (T4) daily for 2 years. Physical examination revealed nonpitting edema, flesh‐colored to erythematous, firm, confluent, polypoid nodules and fissured plaques extending from the shins to the dorsa of both feet (<ref type="figure" target="#f1">Fig. 1</ref>), and round to oval, firm, skin‐colored, walnut‐to‐egg‐sized tumors on all 10 fingers and the ulnar side of the dorsum of the right hand (<ref type="figure" target="#f2">Fig. 2</ref>). The thyroid gland was diffusely enlarged; however, there was no exophthalmos, and extraocular movements were normal. There was no weight loss, loss of appetite, tremor, heat intolerance, diarrhea, or fatigue. On laboratory evaluation, thyroid‐stimulating hormone (TSH) had a markedly low titer of < 0.05 μU/mL (normal: 0.4–5.0), and the TSH receptor antibody was extremely high at 73.8% (normal: < 15%). Serum free triiodothyronine (T3), T4, antimicrosome, and antithyroglobulin antibodies were normal or negative. Skin biopsy samples from the shin and hand disclosed extensive mucin deposition throughout the dermis.</p><figure xml:id="f1"><label>1</label><media mimeType="image" url="urn:x-wiley:00119059:media:IJD1108:IJD_1108_f1"></media><media mimeType="image/gif" url="" rendition="webOriginal"></media><media mimeType="image/gif" url="" rendition="webLoRes"></media><figDesc>
Confluent, firm nodules and plaques on both shins and the dorsa of both feet
</figDesc></figure><figure xml:id="f2"><label>2</label><media mimeType="image" url="urn:x-wiley:00119059:media:IJD1108:IJD_1108_f2"></media><media mimeType="image/gif" url="" rendition="webOriginal"></media><media mimeType="image/gif" url="" rendition="webLoRes"></media><figDesc>
Firm, nonpitting, well‐circumscribed, flesh‐colored masses with orange‐peel appearance of overlying skin and growth of coarse hair on the dorsum of the right hand
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Soyun Cho, <sc>md</sc>
Department of Dermatology
Asan Medical Center
College of Medicine
University of Ulsan
388‐1 Poongnap‐dong, Songpa‐gu
Seoul, 138‐736
South Korea
E‐mail: <email>vickycho@hanmail.net</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:IJD.IJD1108.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="0"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="4"></count><count type="wordTotal" number="645"></count><count type="linksPubMed" number="2"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">Graves' disease presenting as elephantiasic pretibial myxedema and nodules of the hands</title><title type="shortAuthors">Cho et al<i>.</i></title><title type="short">Graves' disease</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>Soyun</givenNames><familyName>Cho</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>Jee‐Ho</givenNames><familyName>Choi</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>Kyung‐Jeh</givenNames><familyName>Sung</familyName><degrees>MD</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1"><personName><givenNames>Kee‐Chan</givenNames><familyName>Moon</familyName><degrees>MD and</degrees></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1"><personName><givenNames>Jai‐Kyoung</givenNames><familyName>Koh</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</unparsedAffiliation></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:lang="en"><p>A 67‐year‐old man presented with a 2‐year history of asymptomatic, firm, multiple nodules and plaques and cerebriform hypertrophy of both lower legs and feet, and well‐defined, skin‐colored, firm nodules and tumors on both hands. He had been diagnosed as having Graves' disease 3 years previously, and had been treated with 10 mg of methimazole and 100 μg of thyroxin (T4) daily for 2 years. Physical examination revealed nonpitting edema, flesh‐colored to erythematous, firm, confluent, polypoid nodules and fissured plaques extending from the shins to the dorsa of both feet (<link href="#f1">Fig. 1</link>), and round to oval, firm, skin‐colored, walnut‐to‐egg‐sized tumors on all 10 fingers and the ulnar side of the dorsum of the right hand (<link href="#f2">Fig. 2</link>). The thyroid gland was diffusely enlarged; however, there was no exophthalmos, and extraocular movements were normal. There was no weight loss, loss of appetite, tremor, heat intolerance, diarrhea, or fatigue. On laboratory evaluation, thyroid‐stimulating hormone (TSH) had a markedly low titer of < 0.05 μU/mL (normal: 0.4–5.0), and the TSH receptor antibody was extremely high at 73.8% (normal: < 15%). Serum free triiodothyronine (T3), T4, antimicrosome, and antithyroglobulin antibodies were normal or negative. Skin biopsy samples from the shin and hand disclosed extensive mucin deposition throughout the dermis.</p><figure xml:id="f1"><label>1</label><mediaResourceGroup><mediaResource alt="image" href="urn:x-wiley:00119059:media:IJD1108:IJD_1108_f1"></mediaResource><mediaResource alt="image" mimeType="image/gif" rendition="webOriginal" href=""></mediaResource><mediaResource alt="image" mimeType="image/gif" rendition="webLoRes" href=""></mediaResource></mediaResourceGroup><caption><p>Confluent, firm nodules and plaques on both shins and the dorsa of both feet</p></caption></figure><figure xml:id="f2"><label>2</label><mediaResourceGroup><mediaResource alt="image" href="urn:x-wiley:00119059:media:IJD1108:IJD_1108_f2"></mediaResource><mediaResource alt="image" mimeType="image/gif" rendition="webOriginal" href=""></mediaResource><mediaResource alt="image" mimeType="image/gif" rendition="webLoRes" href=""></mediaResource></mediaResourceGroup><caption><p>Firm, nonpitting, well‐circumscribed, flesh‐colored masses with orange‐peel appearance of overlying skin and growth of coarse hair on the dorsum of the right hand</p></caption></figure></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Graves' disease presenting as elephantiasic pretibial myxedema and nodules of the hands</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Graves' disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Graves' disease presenting as elephantiasic pretibial myxedema and nodules of the hands</title></titleInfo><name type="personal"><namePart type="given">Soyun</namePart><namePart type="family">Cho</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jee‐Ho</namePart><namePart type="family">Choi</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kyung‐Jeh</namePart><namePart type="family">Sung</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kee‐Chan</namePart><namePart type="family">Moon</namePart><namePart type="termsOfAddress">MD and</namePart><affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jai‐Kyoung</namePart><namePart type="family">Koh</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="other" displayLabel="miscellaneous"></genre><originInfo><publisher>Blackwell Science Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2001-04</dateIssued><copyrightDate encoding="w3cdtf">2001</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="references">4</extent><extent unit="words">645</extent></physicalDescription><abstract lang="en">A 67‐year‐old man presented with a 2‐year history of asymptomatic, firm, multiple nodules and plaques and cerebriform hypertrophy of both lower legs and feet, and well‐defined, skin‐colored, firm nodules and tumors on both hands. He had been diagnosed as having Graves' disease 3 years previously, and had been treated with 10 mg of methimazole and 100 μg of thyroxin (T4) daily for 2 years. Physical examination revealed nonpitting edema, flesh‐colored to erythematous, firm, confluent, polypoid nodules and fissured plaques extending from the shins to the dorsa of both feet (Fig. 1), and round to oval, firm, skin‐colored, walnut‐to‐egg‐sized tumors on all 10 fingers and the ulnar side of the dorsum of the right hand (Fig. 2). The thyroid gland was diffusely enlarged; however, there was no exophthalmos, and extraocular movements were normal. There was no weight loss, loss of appetite, tremor, heat intolerance, diarrhea, or fatigue. On laboratory evaluation, thyroid‐stimulating hormone (TSH) had a markedly low titer of < 0.05 μU/mL (normal: 0.4–5.0), and the TSH receptor antibody was extremely high at 73.8% (normal: < 15%). Serum free triiodothyronine (T3), T4, antimicrosome, and antithyroglobulin antibodies were normal or negative. Skin biopsy samples from the shin and hand disclosed extensive mucin deposition throughout the dermis. Confluent, firm nodules and plaques on both shins and the dorsa of both feet Firm, nonpitting, well‐circumscribed, flesh‐colored masses with orange‐peel appearance of overlying skin and growth of coarse hair on the dorsum of the right hand</abstract><relatedItem type="host"><titleInfo><title>International Journal of Dermatology</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0011-9059</identifier><identifier type="eISSN">1365-4632</identifier><identifier type="DOI">10.1111/(ISSN)1365-4632</identifier><identifier type="PublisherID">IJD</identifier><part><date>2001</date><detail type="volume"><caption>vol.</caption><number>40</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>276</start><end>277</end><total>2</total></extent></part></relatedItem><identifier type="istex">1C8DF41186D35F4A81936D55476A4FCC579F99B8</identifier><identifier type="DOI">10.1046/j.1365-4362.2001.01108.x</identifier><identifier type="ArticleID">IJD1108</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Science Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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