Corticoid Therapy for Pretibial Myxedema

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Abstract
The treatment of pretibial myxedema has given variable results. Corticoids, although promising, also have been inconsistently beneficial. However, an evaluation of the various methods of steroid therapy has not been made to determine its therapeutic value. Furthermore, it is known that high serum LATS [long acting thyroid stimulation] levels are present with this skin lesion and that corticoids lower their levels, but a correlation of the two events was not recorded. The effect of various modes of corticoid therapy on 9 patients with pretibial myxedema and high serum LATS levels is reported in this study. The results show that with high systemic doses of steroids taken for short periods marked improvement in the skin lesions occurred, whereas local application of steroid was less effective. In addition, the previously high LATS levels may be lowered by the drugs, but the individual correlation to the skin changes was poor. Moreover, LATS activity could not be detected in extracts of the myxedematous skin. The results of this study suggest that systemic corticosteroid therapy followed by long-term topical application is a satisfactory method for the clinical management of pretibial myxedema.

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