Image in medicine
Pretibial myxedema
Mixedema pretibial
Elisabeth Gómez Moyano
, Alberto Andamoyo, Alexandra Perea Polak, Leandro Martínez Pilar
Corresponding author
Servicio de Dermatología, Hospital Regional Universitario de Málaga, Málaga, Spain
Read
Not available
Timeswas read the article
Total PDF
Total HTML
Share statistics
array:24 [ "pii" => "S2387020619301251" "issn" => "23870206" "doi" => "10.1016/j.medcle.2019.02.022" "estado" => "S300" "fechaPublicacion" => "2019-05-03" "aid" => "4623" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2018" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2019;152:375" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S002577531830527X" "issn" => "00257753" "doi" => "10.1016/j.medcli.2018.08.011" "estado" => "S300" "fechaPublicacion" => "2019-05-03" "aid" => "4623" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2019;152:375" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 24 "formatos" => array:2 [ "HTML" => 18 "PDF" => 6 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen médica</span>" "titulo" => "Mixedema pretibial" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "375" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pretibial myxedema" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 822 "Ancho" => 900 "Tamanyo" => 97289 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Elisabeth Gómez Moyano, Alberto Andamoyo, Alexandra Perea Polak, Leandro Martínez Pilar" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Elisabeth" "apellidos" => "Gómez Moyano" ] 1 => array:2 [ "nombre" => "Alberto" "apellidos" => "Andamoyo" ] 2 => array:2 [ "nombre" => "Alexandra" "apellidos" => "Perea Polak" ] 3 => array:2 [ "nombre" => "Leandro" "apellidos" => "Martínez Pilar" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020619301251" "doi" => "10.1016/j.medcle.2019.02.022" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020619301251?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577531830527X?idApp=UINPBA00004N" "url" => "/00257753/0000015200000009/v1_201904130623/S002577531830527X/v1_201904130623/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2387020619301159" "issn" => "23870206" "doi" => "10.1016/j.medcle.2019.02.015" "estado" => "S300" "fechaPublicacion" => "2019-05-03" "aid" => "4587" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2019;152:e53" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen médica</span>" "titulo" => "Tuberculous otitis media" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e53" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Otitis media tuberculosa" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 882 "Ancho" => 850 "Tamanyo" => 184518 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Satvinder Singh Bakshi, Ramiya Ramachandran Kaipuzha" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Satvinder Singh" "apellidos" => "Bakshi" ] 1 => array:2 [ "nombre" => "Ramiya Ramachandran" "apellidos" => "Kaipuzha" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020619301159?idApp=UINPBA00004N" "url" => "/23870206/0000015200000009/v1_201904241408/S2387020619301159/v1_201904241408/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S238702061930124X" "issn" => "23870206" "doi" => "10.1016/j.medcle.2019.02.021" "estado" => "S300" "fechaPublicacion" => "2019-05-03" "aid" => "4688" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2019;152:e51-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Sinus dysfunction due to carbamazepine intoxication" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e51" "paginaFinal" => "e52" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Disfunción sinusal secundaria a intoxicación por carbamazepina" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 898 "Ancho" => 2500 "Tamanyo" => 657775 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan Carlos Gómez-Polo, Elena de la Cruz Berlanga, Rosalía Cadenas Chamorro" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Juan Carlos" "apellidos" => "Gómez-Polo" ] 1 => array:2 [ "nombre" => "Elena" "apellidos" => "de la Cruz Berlanga" ] 2 => array:2 [ "nombre" => "Rosalía" "apellidos" => "Cadenas Chamorro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775318306614" "doi" => "10.1016/j.medcli.2018.10.027" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775318306614?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S238702061930124X?idApp=UINPBA00004N" "url" => "/23870206/0000015200000009/v1_201904241408/S238702061930124X/v1_201904241408/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Pretibial myxedema" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "375" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Elisabeth Gómez Moyano, Alberto Andamoyo, Alexandra Perea Polak, Leandro Martínez Pilar" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Elisabeth" "apellidos" => "Gómez Moyano" "email" => array:2 [ 0 => "elisabeth.gomez.moyano@gmail.com" 1 => "eligm80@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Alberto" "apellidos" => "Andamoyo" ] 2 => array:2 [ "nombre" => "Alexandra" "apellidos" => "Perea Polak" ] 3 => array:2 [ "nombre" => "Leandro" "apellidos" => "Martínez Pilar" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Regional Universitario de Málaga, Málaga, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Mixedema pretibial" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 822 "Ancho" => 900 "Tamanyo" => 97289 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 41-year-old male with Graves-Basedow disease (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) diagnosed in 2013, with poor control with antithyroid drugs, so in 2016 he underwent total thyroidectomy. In anatomical pathology, foci of follicular hyperplasia and follicular adenomas were observed. After surgery the patient started treatment with levothyroxine 150<span class="elsevierStyleHsp" style=""></span>μg/day, fasting. In 2018, he consulted for the occurrence of erythematous edematous plaques in the pretibial region (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), with the appearance of orange peel, without worsening of his exophthalmos. Lab test showed TSH 5.51<span class="elsevierStyleHsp" style=""></span>IU/ml (0.4–5), TSH anti-receptor antibodies (<2), free thyroxine, antiperoxidase and anti-thyroglobulin antibodies were within normal limits. A skin biopsy showed edema in the reticular dermis with mucopolysaccharide deposit. The lesions partially improved after clobetasol every 12<span class="elsevierStyleHsp" style=""></span>h for 3 weeks.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Pretibial myxedema is an extrathyroidal manifestation of Graves’ disease that occurs in 1–5% of patients.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The main pathogenic mechanism is the expression of TSH receptor antigens in the dermal fibroblasts, triggering an autoimmune response.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gómez Moyano E, Andamoyo A, Perea Polak A, Martínez Pilar L. Mixedema pretibial. Med Clin (Barc). 2019;152:375.</p>" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 675 "Ancho" => 900 "Tamanyo" => 97058 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 822 "Ancho" => 900 "Tamanyo" => 97289 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015200000009/v1_201904241408/S2387020619301251/v1_201904241408/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015200000009/v1_201904241408/S2387020619301251/v1_201904241408/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020619301251?idApp=UINPBA00004N" ]
