What causes Graves' dermopathy? How is it treated?

Answers from Todd B. Nippoldt, M.D.

Rarely, people with Graves' disease develop Graves' dermopathy, a skin condition characterized by red, swollen skin, usually on the shins and tops of the feet. The texture of the affected skin may be similar to that of an orange peel. Doctors may also refer to it as pretibial myxedema.

This condition results from a buildup of certain carbohydrates in the skin — the cause of which isn't known. Carbohydrate buildup also causes the eye problems associated with Graves' disease. The vast majority of people who develop Graves' dermopathy also have Graves' eye disease.

Milder cases of Graves' dermopathy often improve over time without treatment. Treatment of Graves' dermopathy is usually aimed at correcting the overactive thyroid responsible for Graves' disease. You'll also be advised to quit smoking and to avoid trauma to the skin as much as possible.

Treatment of the affected skin may also include:

  • Cortisone creams to reduce inflammation
  • Cortisone injections
  • Compression stockings

Even with successful treatment of the underlying Graves' disease, you may still have cosmetic issues and have a hard time getting shoes to fit well.

Oct. 30, 2014