Treatment-resistant elephantiasic thyroid dermopathy responding to rituximab and plasmapheresis.
A 44-year-old woman was diagnosed with Graves' disease in 1995 and over the following 12 months developed thyroid dermopathy (pretibial myxoedema). Despite being trialled on multiple recognized therapies over the course of 11 years, the patient's dermopathy progressively worsened. She developed ocular proptosis, elephantiasic thyroid dermopathy and acropachy in both hands. In mid 2006, the patient was started on rituximab and plasmapheresis, with rapid response. The patient's condition stabilized and in October 2009 at the age of 58 years she was able to cease therapy.
Department of Dermatology, Fremantle Hospital, Western Australia, Australia. chrisheyes@gmail.com
Christopher
C
Heyes
Richard
R
Nolan
Michael
M
Leahy
Kurt
K
Gebauer
D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006111:Graves Disease / Q000150:complications; D006229:Hand Dermatoses / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007868:Leg Dermatoses / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D009230:Myxedema / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D010956:Plasmapheresis; D000069283:Rituximab; D016896:Treatment Outcome
D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab