# Graves’ disease thyroid dermopathy: a case report

## TL;DR

This case report describes an unusual presentation of thyroid dermopathy in a young boy with Graves’ disease, showing symptoms that mimicked a lymphatic condition.

## Contribution

The paper presents a rare case of thyroid dermopathy with atypical features and discusses the role of the Koebner phenomenon in its manifestation.

## Key findings

- The patient exhibited non-pitting swelling of the ankle and penis, resembling lymphatic malformation.
- Treatment with cautery worsened the nodules, but intralesional injections and thyroidectomy improved the condition.
- The case highlights the atypical nature of thyroid dermopathy and its potential to mimic other conditions.

## Abstract

Graves’ disease is the autoimmune activation of the thyroid gland causing diffuse enlargement and hyperfunction of the gland. Manifestations of Graves’ disease are multisystemic and include thyroid orbitopathy; pretibial myxedema, also referred to as thyroid dermopathy; and thyroid acropachy, described as a severe form of thyroid dermopathy. Our paper focuses on an atypical case of thyroid dermopathy.

An 11-year-old Saudi male presented with a prominent diffuse goiter and exophthalmos. Investigations were consistent with a diagnosis of Graves’ disease. The physical exam showed diffuse, non-pitting swelling of the ankle and penis, mimicking a lymphatic malformation. Further, multiple nodules were found on the hands and feet. Treatment of the nodules with cautery resulted in more severe nodules.

This report describes rare presentations of thyroid dermopathy mimicking lymphatic malformation. The Koebner phenomenon can explain this patient’s atypical presentations. Intralesional injections of triamcinolone and total thyroidectomy showed clear improvement.