Elephantiasic pretibial myxedema: a novel treatment for an uncommon disorder.
Pretibial myxedema is a known manifestation of Graves' disease. Much less common is the elephantiasis nostras variant, which is often refractory to treatment. We therefore elected to try a new therapy, often used for the management of chronic lymphedema, called complete decongestive physiotherapy. After 6 weeks of intensive treatment, our patient lost 37 pounds and had reduced her edema volume by 47%. Her skin softened with decreased lymph seepage and she became mobile for the first time in years. At a 2-year follow-up visit, she exhibited sustained improvement. This case demonstrates that complete decongestive physiotherapy can provide effective, long-term control of this disease process. We suggest that complete decongestive physiotherapy be considered in patients with severe forms of pretibial myxedema, as well as those with refractory lymphedema.
Susser
Wendy S
WS
Section of Dermatology, Dartmouth-Hitchcock Medical Center, USA.
Heermans
Amanda G
AG
Chapman
M Shane
MS
Baughman
Richard D
RD
D000368:Aged; D001707:Biopsy, Needle; D004604:Elephantiasis / Q000209:etiology / Q000473:pathology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007868:Leg Dermatoses / Q000209:etiology / Q000473:pathology / Q000534:rehabilitation*; D009230:Myxedema / Q000209:etiology / Q000473:pathology* / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D016896:Treatment Outcome