Cutaneous manifestations in autoimmune thyroid disease: a cross-sectional study

Autoimmune thyroid diseases, mainly Hashimoto's thyroiditis and Graves' disease, are chronic disorders causing thyroid dysfunction. Thyroid hormones regulate skin, hair, and nails; therefore, various dermatological manifestations may occur. This study aimed to evaluate the prevalence of dermatological findings in autoimmune thyroid diseases and their association with laboratory parameters.

This cross-sectional analytical study included 85 individuals aged ≥18 years presenting to the endocrinology outpatient clinic. Diagnosis was based on clinical findings, antibody positivity (anti-TPO/anti-Tg), and, when available, ultrasound. Participants were divided into autoimmune thyroid disease (n = 63) and control (n = 22) groups. All underwent dermatological examination by the same team. Xerosis cutis, hair loss, pruritus, and seborrheic dermatitis were assessed using standard definitions. Laboratory parameters included TSH, fT3, fT4, anti-TPO, and anti-Tg. Statistical analyses included parametric/nonparametric tests, correlation, ROC, and logistic regression (p < 0.05).

Dermatological findings were significantly more frequent in the disease group (55.6% vs. 27.3%, p < 0.05). Xerosis cutis showed a significant positive association (r = 0.248, p < 0.05), while hair loss, pruritus, and seborrheic dermatitis were not significant. Autoimmune thyroid disease correlated strongly with anti-TPO (r = 0.731) and weakly with TSH (r = 0.292; p < 0.05). In multivariable analysis, elevated anti-TPO (OR = 3.18), higher TSH (OR = 1.82), and presence of skin findings (OR = 4.43) were independently associated with disease (Nagelkerke R² = 0.89).

Dermatological findings, particularly xerosis cutis, are more common in autoimmune thyroid diseases. Alongside anti-TPO and TSH, skin findings are independently associated and may aid clinical evaluation.