Pretibial myxoedema: A clinical and pathological study

Abstract

Long acting thyroid stimulator (LATS) has been implicated in the pathogenesis of pretibial myxoedema (PTM). The objective of the present study was to seek evidence for a pathogenic role for LATS in PTM by immunofluorescent antibody study of skin biopsies from these lesions. Six patients (5 males and 1 female) with PTM were studied: one had associated thyroid acropachy; 4 were thyrotoxic on presentation, one was euthyroid and the sixth hypothyroid. Immunofluorescent antibody studies showed no difference in the deposition of immunoglobulin G (IgG) in the skins from PTM compared to normal skins adjacent to the lesions, skins of thyrotoxic controls without PTM, and skins of 'normal control' subjects. The results gave no support to the hypothesis that PTM results from a local antigen-antibody tissue reaction.