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Skin-nontumor
Other dermatoses
Myxedema
Reviewer: Mowafak Hamodat MB.CH.B, MSc., FRCPC, Eastern Health, St. Johns (Canada) (see Reviewers
page)
Revised: 1 August 2011, last major update August 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.
Definition
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● Thick, dry, and waxy skin due to accumulation of mucopolysaccharides in dermis; similar to that in orbital tissues, caused by excess TSH secretion or hypothyroidism
● Often in pretibial skin
● Localized or generalized
● Elephantiasis: extreme disease
Treatment
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● Self-limiting
Case reports
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● 75-year-old woman with Grave’s disease
Clinical description
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● Pink, yellow and waxy plaques and nodules on the antero-lateral aspect of leg
● Indurations with prominence of follicles giving rise to peau d’orange appearance, and secondary hypertrichosis is occasionally marked
● Asymptomatic or mildly pruritic
Micro description
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● Epidermis is hyperkeratotic, with follicular plugging, and may be papillomatous and acanthotic
● Dermis shows separation of collagen bundles by large quantities of mucin
● Satellite fibroblasts are evident, but no increase in numbers except in elephantiasis form
Positive stains
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● Mucicarmine, Hale’s colloidal iron, PAS+ diastase resistant
Negative stains
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● Direct immunofluorescence is usually negative, although granular deposits of IgM have been identified
Additional references
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End of Skin-nontumor > Other dermatoses > Myxedema
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