Myxoedema diffuse - Altmeyers Encyclopedia

Synonym(s)

diffuse myxodermia in hypothyroidism; Myxodermia diffuse in hypothyroidism; Myxoedema real; True myxoedema

Definition
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Diffuse accumulation of acid mucopolysaccharides and fluid in the skin in hypothyroidism (see below for classification of mucinoses).

Etiopathogenesis
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Congenital (primary myxoedema) or acquired (secondary myxoedema) disturbance in the synthesis of thyroid hormones (e.g. inflammation, see also postoperative myxoedema)

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Clinical features
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Pale, dry, bloated, edematous skin. No dents after finger pressure. Bloated face, dumpy speech in macroglossia. Yellowish-white skin colour, especially on palmae and plantae and in the nasolabial area. Hyperkeratotic skin in places, also follicular keratoses, general sebostasis.

Laboratory
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Primary hypothyroidism: T3 and T4 decrease, TSH increase. Secondary hypothyroidism: T3, T4 and TSH decrease. Also carotenoids.

Histology
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Accumulation of basic substances, especially in the upper corium around hair follicles and blood vessels, histochemical mucin detection.

Therapy
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Treatment by internists. Substitution therapy after endocrinological clarification of the genesis. With hormone substitution, the skin changes usually decrease as well.