Myxedema 613896 213369311 2008-05-19T00:57:03Z 75.72.167.199 /* Causes */ {{Infobox_Disease | Name = Myxoedema | Image = | Caption = | ICD10 = {{ICD10|E|03|9|e|00}} | ICD9 = {{ICD9|244.9}} | DiseasesDB = 6558 | ICDO = | OMIM = | MedlinePlus = 000353 | eMedicineSubj = med | eMedicineTopic = 1581 | eMedicine_mult = {{eMedicine2|derm|347}} | MeshID = D009230 | }} '''Myxedema''' (British English: '''myxoedema''') is a skin and tissue disorder usually due to severe prolonged '''[[hypothyroidism]]'''. Hypothyroidism can be caused by atrophic disease, [[Hashimoto's thyroiditis]], surgical removal of the [[thyroid]], and rarer conditions. Partial forms of myxedema, especially of the lower legs (called [[pretibial myxedema]]), occasionally occur in adults with [[Graves' disease]], a cause of hyperthyroidism; or also Hashimoto's thyroiditis without severe hypothyroidism. ==Symptoms== Myxedema usually presents itself with some of the following symptoms: * Skin thickening * Coarse skin * Change in facial appearance * Thickening nose * Swollen lips * Puffiness around the eyes * Jelly-like infiltrations in [[subcutaneous]] tissues * Slow speech * Mental dullness * Lethargy * Mental problems * Dry skin * Yellow skin * Swollen [[subcutaneous]] tissue * Weight gain * [[Constipation]] * Thinning hair * Brittle hair * Bald patches * Muscle pains * [[Deafness]] * [[Hearing impairment]] * [[Carpal tunnel syndrome]] ==Causes== Myxedema, stemming from both the [[hyperthyroid]] and [[hypothyroid]] conditions, results from the accumulation of increased amounts of [[hyaluronic acid]] and [[chondroitin sulfate]] in the [[dermis]] in both lesional and normal skin. The mechanism that causes myxedema is still not yet understood, although animal model studies suggest that [[thyroid]] [[hormones]] affect the [[synthesis]] and [[catabolism]] of [[mucopolysaccharides]] and [[collagen]] by dermal [[fibroblasts]]. The fibroblasts in the [[Orbit (anatomy)|orbital]] and [[pretibial]] [[dermis]] share [[antigenic]] sites that underlie the [[autoimmune]] process that causes [[Graves' disease]]. This cross-reaction may contribute to the development of myxedema long after normal levels of thyroid hormones have been restored by treatment. ==Treatment== Treatment for myxedema is difficult. Systemic or [[intralesional]] [[glucocorticoids]], [[topical]] [[glucocorticoids]] under [[occlusion]] or high-dose [[intravenous]] [[immunoglobulin]] have been reported to offer some relief to patients. Treatment should follow correction of the original hyperthyroidism/hypothyroidism. ==See also== Severe hypothyroidism in a child is called [[Cretinism]]. {{Endocrine pathology}} [[Category:Diseases]] [[es:Mixedema]] [[fr:Myxœdème]] [[pt:Mixedema]]