[Pretibial myxedema: pathogenetic features and clinical aspects]

Area of Science:

• Endocrinology and Dermatology
• Autoimmune disease manifestations
• Thyroid-associated ophthalmopathy and dermopathy

Background:

• Pretibial myxedema (PTM), or thyroid dermopathy, is a rare extrathyroidal manifestation of Graves' disease.
• Characterized by mucinous skin changes, primarily on the anterior tibial surface, severe cases can cause lymphatic congestion and disability.
• The exact pathogenesis, including the role of TSHR antibodies and potential IGF-1 receptor involvement, remains under investigation.

Purpose of the Study:

• To review recent scientific data on the etiopathogenesis of Pretibial Myxedema (PTM).
• To summarize current understanding and management strategies for patients with PTM.
• To highlight the need for clinical guidelines in diagnosing and treating thyroid dermopathy.

Main Methods:

• Review of recent scientific literature on PTM etiopathogenesis and management.
• Analysis of diagnostic approaches, including preventive examinations and indications for biopsy.
• Compilation of risk reduction strategies for patients with Graves' disease.

Main Results:

• PTM typically presents in various forms (diffuse, tumorous, plaque-like, elephantiasic) on the anterior and lateral tibial surfaces.
• Early diagnosis relies on regular preventive examinations of the pretibial area; biopsy is reserved for complex cases.
• Risk reduction measures include maintaining euthyroidism, smoking cessation, injury prevention, and avoiding constrictive footwear.

Conclusions:

• Understanding the complex etiopathogenesis of PTM is essential for effective management.
• Current management focuses on symptom control, risk factor modification, and supportive care.
• There is a significant need for established clinical guidelines for the diagnosis and treatment of thyroid dermopathy.