Pretibial myxedema is a skin condition that causes plaques of thick, scaly skin and swelling of your lower legs. This condition is a form of Graves’ disease and can affect people diagnosed with thyroid conditions. Symptoms are cosmetic and the condition doesn’t always need treatment.
Pretibial myxedema, also known as Graves’ dermopathy, is a form of Graves’ disease that affects your skin. The condition causes carbohydrates and sugar compounds (glycosaminoglycans or mucopolysaccharides) to build up deep within your skin and tissue. Pretibial myxedema affects your lower legs and causes lumps, scaling plaques and swelling (edema).
“Pretibial” refers to the front (anterior) of your tibia. This is your shin bone. You can find your shin bone underneath your knee. “Myxedema” means swelling of the tissues underneath your skin.
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Pretibial myxedema can affect anyone, but it’s most common among people who:
There are four different types of pretibial myxedema that include:
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Symptoms of pretibial myxedema include:
Early symptoms of pretibial myxedema include a lump on your skin that’s firm. This lump can change in size or merge with other lumps.
Pretibial myxedema symptoms most often affect:
Symptoms that affect the face may be the result of Graves’ disease or a thyroid condition.
A buildup of sugar compounds (glycosaminoglycans or mucopolysaccharides) in the dermis and hypodermis layers of your skin and tissue cause pretibial myxedema. The exact reason for these compounds to buildup in your skin is unknown, but research suggests the cause may be from:
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A healthcare provider will diagnose pretibial myxedema after taking a complete medical history and performing a physical exam, where they’ll review your symptoms. To confirm a diagnosis, your provider will offer a blood test to check your thyroid levels. A skin biopsy can detect the condition and may detect high levels of glycosaminoglycans in your skin.
Treatment for pretibial myxedema isn’t always necessary, as most of the symptoms are cosmetic. But treatment options are available and include:
Surgery to remove the lumps underneath your skin is successful but not recommended, as there’s a high risk of the lumps returning after your skin heals. This happens because your body views your surgery site as an injury, and pretibial myxedema is common at sites of injuries.
Your provider might offer one of the following medications to relieve your symptoms of pretibial myxedema:
Before taking new medications, talk to your provider about the potential side effects, how often you should take the medicine and the current medications you take to avoid drug interactions.
The length of time that you’ll have symptoms of pretibial myxedema varies based on the severity of your condition. It could take a few weeks to a few months for your symptoms to go away with treatment. Without treatment, it could take a few years for the condition to go away on its own. The condition could come back after it goes away if you injure the lower part of your legs.
There’s no sure way to prevent pretibial myxedema, but you can reduce your risk of acquiring the condition by:
A prognosis, or outcome, for pretibial myxedema is good. The condition doesn’t require treatment if your symptoms are only cosmetic. The condition will clear up on its own if you have a mild case. If you have a severe case of pretibial myxedema, you still have a good prognosis, but it could take several years before the condition goes away completely.
There’s a risk that pretibial myxedema could come back after it goes away. This happens most often if you injure the lower part of your legs. Talk to your provider if your symptoms come back after they’ve gone away. If you experience symptoms of pain or severe itchiness, visit your provider.
Both pretibial myxedema and erythema nodosum are conditions that affect your skin, most often the skin on your lower legs, located below your knee. The symptoms are different for each condition:
A note from Cleveland Clinic
Pretibial myxedema is a condition that doesn’t usually cause symptoms that need treatment. The condition will go away on its own, but treatment is available if the physical symptoms of the condition are bothersome. Wearing compression socks or stockings can help reduce swelling to make you more comfortable. Talk to your provider if you experience pain or severe itching in your lower legs.
Last reviewed on 12/09/2022.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy