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Localized, Alopecic Myxedema of the Scalp

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Abstract

Localized myxedema is a rare complication ofautoimmune thyroid diseases including the Hashimoto thyroiditis and Graves’ disease.Localized myxedema results from the accumulation of glycosaminoglycans in the dermis and subcutaneous layer of the skin.

Fibroblast-produced hyaluronic acid is the mainglycosaminoglycan in localized myxedema. Localized myxedema presents bilaterally with a “boggy” thickening of the skin. Lesions classically have “waxy” swelling and induration.Myxedematous lesions of the skin most often appear on the anterior aspects of the legs and dorsum of the feet. They are often asymptomatic. Targeted treatment to cutaneous lesions is usually reserved for symptomatic cases.

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