Short-term resolution of psoriasis after total thyroidectomy for euthyroid multinodular goitre.
A 36-year-old Chinese female with an 8-year history of chronic, generalized plaque psoriasis demonstrated a marked improvement of the disease after removal of an intercurrent euthyroid multinodular goitre. Thyroxine was commenced immediately postoperatively. No thyroid antibodies were detected and thyroid function and calcium levels remained within normal limits both pre- and postoperatively. Four weeks following surgery, narrow-band ultraviolet B (nbUVB) therapy was recommenced for recurrent psoriasis. The manifestations of psoriasis at this stage were less severe than before thyroidectomy and responded well to treatment, whereas before surgery the response to therapy had been poor. One year following total thyroidectomy, the patient received very effective psoriasis control with nbUVB therapy. The possible role of surgery and thyroid hormones in altering the pathogenesis of psoriasis in the acute setting is clearly of interest and warrants further research consideration.
The University of Sydney, Department of Dermatology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia. jkuchel@med.usyd.edu.au
Johanna
J
Kuchel
Michael
M
Barakate
Leigh
L
Delbridge
Gaurav
G
Agarwal
John
J
Beattie
Ross
R
Barnetson
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006042:Goiter / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D011184:Postoperative Period; D011565:Psoriasis / Q000150:complications / Q000175:diagnosis / Q000532:radiotherapy*; D012720:Severity of Illness Index; D013960:Thyroid Function Tests; D013965:Thyroidectomy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000379:methods*