title: Elephantiasic pretibial myxedema: a novel treatment for an uncommon disorder.
abstract: 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.
authors: Section of Dermatology, Dartmouth-Hitchcock Medical Center, USA.
authors: Wendy S
authors: WS
authors: Susser
authors: Amanda G
authors: AG
authors: Heermans
authors: M Shane
authors: MS
authors: Chapman
authors: Richard D
authors: RD
authors: Baughman
mesh_terms: 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