Zhang F, Lin XY, Chen J, Peng SQ, Shan ZY, Teng WP, Yu XH. Intralesional and topical glucocorticoids for pretibial myxedema: A case report and review of literature. World J Clin Cases 2018; 6(14): 854-861 [PMID: 30510955 DOI: 10.12998/wjcc.v6.i14.854]
Corresponding Author of This Article
Xiao-Hui Yu, MD, PhD, Professor, Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China. yuxh@cmu1h.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Fan Zhang, Xin-Yue Lin, Jian Chen, Shi-Qiao Peng, Zhong-Yan Shan, Wei-Ping Teng, Xiao-Hui Yu, Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: All the authors materially participated in this work, read and approved the final manuscript; Zhang F is the first author for this study; Yu XH is the corresponding author supervising this work; Zhang F and Lin XY managed the case and drafted the manuscript; Zhang F, Lin XY, Chen J and Peng SQ performed data analysis and interpretation based on literature review; Yu XH, Shan ZY and Teng WP reviewed the manuscript; Lin XY and Chen J prepared histopathological results; All authors participated sufficiently in the work and take public responsibility for its content.
Informed consent statement: Written consent was obtained from the patient. The patient consented to the publication of medical data (including figures from diagnostic imaging results and from histological examination results).
Conflict-of-interest statement: All authors declare no conflicts of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xiao-Hui Yu, MD, PhD, Professor, Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China. yuxh@cmu1h.com
Telephone: +86-24-83283135
Received: August 8, 2018 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 Processing time: 110 Days and 16.6 Hours
ARTICLE HIGHLIGHTS
Case characteristics
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.
Clinical diagnosis
It was clearly diagnosed as pretibial myxedema (PTM).
Laboratory diagnosis
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.
Pathological diagnosis
The pathological examination confirmed the diagnosis of PTM.
Treatment
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.
Related reports
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.
Experiences and lessons
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.
