Abstract
Thyroid disorders commonly have dermatologic manifestations. The purpose of the present
chapter is to review and emphasize potential clinical dermatologic findings that can
occur with Graves' disease, hypothyroidism and thyroid cancer. In autoimmune diseases
such as Graves' disease and Hashimoto's thyroiditis the skin manifestations may be
related to either thyroid hormone levels themselves or to the associated T and/or
B cell abnormalities. Thyroid cancer may be associated with various syndromes that
could have significant skin manifestations.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinics in DermatologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Cutaneous manifestations of endocrine disorders: a guide for dermatologists.Am J Clin Dermatol. 2003; 4: 315-331
Leonhardt JM, Heymann WR. Thyroid disease and the skin. Dermatol Clin 2002;20:473-81, vii.
- Hyperthyroidism, Chapter 41.in: Becker K.A. Principles and practice of endocrinology and metabolism. 2nd ed. J.B. Lippincott, Philadelphia (Pa)1995: 367-385
- Dominant inheritance of resistance to thyroid hormone not linked to defects in the thyroid hormone receptor alpha or beta genes may be due to a defective cofactor.J Clin Endocrinol Metab. 1996; 81 ([see comments]): 4196-4203
- Recognizing the faces of hypothyroidism.Hosp Pract (Off Ed). 1999; 34: 93-96
- Subclinical thyroid disease: clinical applications.JAMA. 2004; 291: 239-243
- Subclinical thyroid disease: scientific review and guidelines for diagnosis and management.JAMA. 2004; 291: 228-238
- The diagnostic evaluation and management of hyperthyroidism due to Graves' disease, toxic nodules and toxic multinodular goiter.in: Cooper D.S. Marcel Dekker, Inc, New York2001: 33-92
- Transient Graves' hyperthyroidism during pregnancy in a patient with Hashimoto's hypothyroidism.Thyroid. 2005; 15: 725-729
- Current trends in the management of well differentiated papillary thyroid carcinoma.J Clin Endocrinol Metab. 1996; 81: 333-339
- Skin disorders and thyroid diseases.J Endocrinol Invest. 2001; 24: 628-638
- Graves' autoantibodies to extrathyroidal TSH receptor: their role in ophthalmopathy and pretibial myxedema.Acta Endocrinol Suppl (Copenh). 1987; 281: 344-347
- Thyroid and the eye.Curr Opin Ophthalmol. 2002; 13: 352-356
- Pretibial myxedema: pathophysiology and treatment options.Am J Clin Dermatol. 2005; 6: 295-309
- Thyroid acropachy: report of 40 patients treated at a single institution in a 26-year period.J Clin Endocrinol Metab. 2002; 87: 5435-5441
- Clinical features and outcome of subacute thyroiditis in an incidence cohort: Olmsted County, Minnesota, study.J Clin Endocrinol Metab. 2003; 88: 2100-2105
- Heterogeneity of TSH receptor-binding antibodies in Hashimoto's thyroiditis and Graves' disease.Am J Med Sci. 1990; 299: 291-297
- Graves' immunoglobulins activate phospholipase A2 by recognizing specific epitopes on thyrotropin receptor.J Clin Endocrinol Metab. 1999; 84: 3283-3292
- TSH receptor expression in orbital tissue and its role in the pathogenesis of Graves' ophthalmopathy.J Endocrinol Invest. 2004; 27: 216-220
- Pathogenesis of Graves' ophthalmopathy.N Engl J Med. 1993; 329: 1468-1475
- Preradial myxedema: a case report.Ann Acad Med Singapore. 1996; 25: 281-282
- Preradial myxedema in thyroid disease.Arch Dermatol. 1981; 117: 635-638
- Thyroid disease.Prim Care. 2003; 30: 625-640
- Atypical clinical features of hypo- and hyperthyroidism in elderly age.Ther Hung. 1991; 39: 167-174
- The euthyroid sick syndrome: is there a physiologic rationale for thyroid hormone treatment?.J Endocrinol Invest. 2003; 26: 1174-1179
- Alterations in thyroid function in patients with systemic illness: the euthyroid sick syndrome.Endocr Rev. 1982; 3: 164-217
- The production and characterization of thyroid-derived T-cell lines in Graves' disease and Hashimoto's thyroiditis.Clin Immunol Immunopathol. 1986; 39: 139-150
- Autoantibody against Na+/I− symporter in the sera of patients with autoimmune thyroid disease.Biochem Biophys Res Commun. 1996; 224: 92-95
- Thyroid-infiltrating T lymphocyte subsets in Hashimoto's thyroiditis.J Clin Endocrinol Metab. 1983; 56: 1164-1168
- Characterization of monoclonal thyroid-stimulating and thyrotropin binding-inhibiting autoantibodies from a Hashimoto's patient whose children had intrauterine and neonatal thyroid disease.J Clin Endocrinol Metab. 1997; 82: 3998-4009
- Autoimmune thyroid diseases: etiology, pathogenesis, and dermatologic manifestations.J Am Acad Dermatol. 2003; 48 ([quiz 660-2]): 641-659
- Hashimoto's thyroiditis with heterogeneous antithyrotropin receptor antibodies: unique epitopes may contribute to the regulation of thyroid function by the antibodies.J Clin Endocrinol Metab. 2000; 85: 2116-2121
- Hodgkin's lymphoma of the thyroid: a clinicopathologic study of five cases and review of the literature.Mod Pathol. 2005;
- Thyroiditis: differential diagnosis and management.Am Fam Physician. 2000; 61: 1047-1052
- Postpartum thyroiditis: long-term follow-up.Thyroid. 2005; 15: 1177-1181
Stagnaro-Green A. Recognizing, understanding, and treating postpartum thyroiditis. Endocrinol Metab Clin North Am 2000;29:417-30, ix.
- Clinical review 152: postpartum thyroiditis.J Clin Endocrinol Metab. 2002; 87: 4042-4047
- Postpartum thyroiditis.Best Pract Res Clin Endocrinol Metab. 2004; 18: 303-316
- Thyroid autoimmunity and the risk of miscarriage.Best Pract Res Clin Endocrinol Metab. 2004; 18: 167-181
- The epidemiologic characteristics and clinical course of ophthalmopathy associated with autoimmune thyroid disease in Olmsted County, Minnesota.Trans Am Ophthalmol Soc. 1994; 92: 477-588
- Clinical features of Graves' ophthalmopathy in an incidence cohort.Am J Ophthalmol. 1996; 121: 284-290
- Oxygen free radicals in interleukin-1beta–induced glycosaminoglycan production by retro-ocular fibroblasts from normal subjects and Graves' ophthalmopathy patients.Thyroid. 1999; 9: 297-303
K.D. Burman. Thyroid disease and osteoporosis. Hosp Pract (Off Ed) 1997;32:71-3, 78-85; discussion 85-6.
- Graves' ophthalmopathy: current concepts regarding pathogenesis and management.Endocr Rev. 1993; 14 ([Review]): 747-793
- Short-term hyperthyroidism followed by transient pituitary hypothyroidism in a very low birth weight infant born to a mother with uncontrolled Graves' disease.Pediatrics. 2001; 107: E57
- Congenital hypothyroidism detected by neonatal screening: relationship between biochemical severity and early clinical features.Arch Dis Child. 1992; 67: 87-90
- Congenital hypothyroidism: etiologies, diagnosis, and management.Thyroid. 1999; 9: 735-740
- Autoimmune regulator-1 messenger ribonucleic acid analysis in a novel intronic mutation and two additional novel AIRE gene mutations in a cohort of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy patients.J Clin Endocrinol Metab. 2005; 90: 4930-4935
- Is long-term levothyroxine therapy safe?.Arch Intern Med. 1990; 150: 2010-2013
- Thyroid hormone levels affected by time of blood sampling in thyroxine-treated patients.Thyroid. 1993; 3: 82-85
- l-Thyroxine dosage: a reevaluation of therapy with contemporary preparations.Ann Intern Med. 1986; 105: 11-15
- Optimal thyrotropin level: normal ranges and reference intervals are not equivalent.Thyroid. 2005; 15: 1035-1039
- Update in endocrinology.Ann Intern Med. 2005; 143: 673-682
- Levothyroxine therapy for hypothyroidism: should we abandon conservative dosage titration?.Arch Intern Med. 2005; 165: 1683-1684
- The evidence for a narrower thyrotropin reference range is compelling.J Clin Endocrinol Metab. 2005; 90: 5483-5488
- A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma.J Clin Endocrinol Metab. 2003; 88: 1433-1441
- Management of papillary and follicular (differentiated) thyroid cancer: new paradigms using recombinant human thyrotropin.Endocr Relat Cancer. 2002; 9: 227-247
- Multiple endocrine neoplasia type 2: evaluation of the genotype-phenotype relationship.Arch Surg. 2003; 138 ([discussion 416]): 409-416
- Management of undifferentiated thyroid cancer.Baillieres Best Pract Res Clin Endocrinol Metab. 2000; 14: 615-629
- Primary non-Hodgkin's lymphoma of the thyroid gland: a population based study.Histopathology. 1996; 28: 25-32
- Current trends in the management of well differentiated papillary thyroid carcinoma.J Clin Endocrinol Metab. 1996; 81: 333-339
- Management of low-risk well-differentiated thyroid cancer based only on thyroglobulin measurement after recombinant human thyrotropin.Thyroid. 2002; 12: 583-590
- Unusual types of thyroid neoplasms.Endocrinol Metab Clin North Am. 1996; 25: 49-68
- Papillary and follicular variant of papillary carcinoma of the thyroid: initial presentation and response to therapy.Otolaryngol Head Neck Surg. 2005; 132: 840-844
- Ultrasound-guided fine-needle aspiration and thyroid disease.Otolaryngol Head Neck Surg. 2000; 123: 700-705
- Using baseline and recombinant human TSH-stimulated Tg measurements to manage thyroid cancer without diagnostic (131)I scanning.J Clin Endocrinol Metab. 2002; 87: 1486-1489
- Cutaneous manifestations of thyroid cancer: a report of four cases and review of the literature.J Clin Pathol. 2004; 57: 435-438
- Choroidal and skin metastases from papillary thyroid cancer: case and a review of the literature.J Clin Endocrinol Metab. 2004; 89: 5303-5307
- Skin metastases from unknown origin: role of immunohistochemistry in the evaluation of cutaneous metastases of carcinoma of unknown origin.J Cutan Pathol. 2005; 32: 561-566
- Metastatic follicular thyroid carcinoma diagnosed by fine needle aspiration cytology: a report of 3 cases.Acta Cytol. 2005; 49: 177-180
- Metastatic papillary carcinoma of the thyroid.J Cutan Pathol. 2004; 31: 509-512
- Unusual distant metastases from papillary thyroid carcinoma.J Assoc Physicians India. 2002; 50: 1338
- Management of patients with hereditary medullary thyroid carcinoma.J Pediatr Surg. 2005; 40: 1214
- Multiple endocrine neoplasia syndrome: genetic basis for clinical management.Curr Opin Oncol. 2005; 17: 7-12
- Molecular genetic alterations in adrenal and extra-adrenal pheochromocytomas and paragangliomas.Endocr Pathol. 2003; 14: 329-350
- Endocrine tumor syndromes in infancy and childhood.Endocr Pathol. 2004; 15: 223-226
- Management of patients with hereditary medullary thyroid carcinoma.Eur J Pediatr Surg. 2004; 14: 375-383
- Genetic testing in endocrinology: lessons learned from experience with multiple endocrine neoplasia type 2 (MEN2).Growth Horm IGF Res. 2004; 14: S150-S157
- Molecular pathogenesis of MEN2-associated tumors.Fam Cancer. 2005; 4: 3-7
- Diagnosis and management of medullary thyroid carcinoma.Clin Lab Med. 2004; 24: 49-83
- Multiple endocrine neoplasia 2B syndrome due to codon 918 mutation: clinical manifestation and course in early and late onset disease.World J Surg. 2004; 28: 1305-1311
- Multiple endocrine neoplasia type 2B in a Chinese patient.Hong Kong Med J. 2004; 10: 206-209
- Clinical manifestations of familial medullary thyroid carcinoma.Biomed Pharmacother. 2004; 58: 348-350
- Multiple endocrine neoplasia type 2B caused by a single point mutation in RET proto-oncogene in a Chinese patient.Chin Med J (Engl). 2004; 117: 1262-1264
- Multiple endocrine neoplasia 2B (MEN 2B)/MEN 3.Dermatol Clin. 1995; 13: 99-103
- Adrenal ganglioneuromas in children with multiple endocrine neoplasia type 2: a report of two cases.J Clin Endocrinol Metab. 2005; 90: 4383-4387
- Ganglioneuromas and renal anomalies are induced by activated RET(MEN2B) in transgenic mice.Oncogene. 1999; 18: 877-886
- The lentiginoses: cutaneous markers of systemic disease and a window to new aspects of tumourigenesis.J Med Genet. 2005; 42: 801-810
- Primary pigmented nodular adrenocortical disease: paradoxical responses of cortisol secretion to dexamethasone occur in vitro and are associated with increased expression of the glucocorticoid receptor.J Clin Endocrinol Metab. 2003; 88: 3931-3937
- Protein kinase-A activity in PRKAR1A-mutant cells, and regulation of mitogen-activated protein kinases ERK1/2.Hum Mol Genet. 2003; 12: 1475-1484
- Clinical and molecular genetics of primary pigmented nodular adrenocortical disease.Arq Bras Endocrinol Metabol. 2004; 48: 637-641
- Pathology and molecular genetics of the pituitary gland in patients with the ‘complex of spotty skin pigmentation, myxomas, endocrine overactivity and schwannomas’ (Carney complex).Front Horm Res. 2004; 32: 253-264
McDonnell JK. Cardiac disease and the skin. Dermatol Clin 2002;20:503-11, vii.
- Germline mutation of the PTEN gene in a Japanese patient with Cowden's disease.Int J Oncol. 2001; 18: 1017-1022
- Cowden's disease: clinical and molecular genetic findings in a patient with a novel PTEN germline mutation.Br J Dermatol. 2003; 148: 1040-1046
- Hamartomatous polyposis syndromes: molecular genetics, neoplastic risk, and surveillance recommendations.Ann Surg Oncol. 2001; 8: 319-327
- Molecular basis of thyroid cancer: molecular basis of thyroid cancer.Thyroid. 2005; 15: 1109
- Multiple hamartoma syndrome. A report of a new case with associated carcinoma of the uterine cervix and angioid streaks of the eyes.J Am Acad Dermatol. 1980; 2: 303-308
- Cowden disease with Lhermitte-Duclos disease: case report.Can J Neurol Sci. 2004; 31: 542-549
- Multiple hamartoma syndrome (Cowden's disease) associated with renal cell carcinoma and primary neuroendocrine carcinoma of the skin (Merkel cell carcinoma).Am J Clin Pathol. 1992; 97: 705-712
- Germline PTEN mutations in Cowden syndrome–like families.J Med Genet. 1998; 35: 881-885
- Lhermitte-Duclos disease and Cowden disease: clinical and genetic study in five patients with Lhermitte-Duclos disease and literature review.Acta Neurochir (Wien). 2004; 146: 679-690
- Thyroid diseases.in: Korenman S.G. Current Medicine, Inc. Blackwell Publishers, The Atlas of Clinical Endocrinology, Philadelphia1999
Article info
Identification
Copyright
© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
