Skin inflammatory (nontumor)
Dermal collagen and elastic tissue alterations, and cutaneous deposit

Author: Mowafak Hamodat, M.D., MB.CH.B, MSc., FRCPC (see Authors page)

Revised: 17 October 2018, last major update August 2011

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Myxedema [title] skin

Cite this page: Hamodat, M. Myxedema. website. Accessed December 12th, 2018.
Definition / general
  • Thick, dry, and waxy skin due to accumulation of mucopolysaccharides in dermis; similar to that in orbital tissues, caused by excess TSH secretion or hypothyroidism
  • Often in pretibial skin
  • Localized or generalized
  • Elephantiasis: extreme disease
Clinical features
  • Pink, yellow and waxy plaques and nodules on the antero-lateral aspect of leg
  • Indurations with prominence of follicles giving rise to peau d’orange appearance, and secondary hypertrichosis is occasionally marked
  • Asymptomatic or mildly pruritic
Case reports
  • Self-limiting
Microscopic (histologic) description
  • Epidermis is hyperkeratotic, with follicular plugging, and may be papillomatous and acanthotic
  • Dermis shows separation of collagen bundles by large quantities of mucin
  • Satellite fibroblasts are evident, but no increase in numbers except in elephantiasis form
Positive stains
Negative stains
  • Direct immunofluorescence is usually negative, although granular deposits of IgM have been identified
Additional references