{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T23:22:38Z","timestamp":1773271358110,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2002,8,28]],"date-time":"2002-08-28T00:00:00Z","timestamp":1030492800000},"content-version":"vor","delay-in-days":58,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2002,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pretibial myxedema (PM) is a localized thickening of the pretibial skin due to accumulation of acid mucopolysacharides (glycosaminoglycans). Its pathogenesis is still under investigation. Pretibial myxedema, exophthalmus and thyroid acropachy are the classic extrathyroidal manifestations of Graves\u2019 disease. Almost invariably, PM follows the onset of ophthalmopathy, developing after the diagnosis and treatment of hyperthyroidism. Pretibial myxedema preceding Graves\u2019 ophthalmopathy is rare.<\/jats:p><jats:p>We report the case of a 28\u2010year\u2010old Greek woman, who presented with multiple, asymptomatic nodules and plaques of the lower legs in the absence of other physical findings. Histopathologic examination revealed deposition of mucopolysacharides in the lower dermis. Laboratory investigation showed elevated serum T3 and T4 and depressed TSH levels. In our patient, pretibial myxedema was the earliest manifestation, leading to the diagnosis of Graves\u2019 disease.<\/jats:p>","DOI":"10.1046\/j.1468-3083.2002.00567.x","type":"journal-article","created":{"date-parts":[[2003,3,12]],"date-time":"2003-03-12T04:42:08Z","timestamp":1047444128000},"page":"380-383","source":"Crossref","is-referenced-by-count":23,"title":["Pretibial myxedema as the initial manifestation of Graves\u2019 disease"],"prefix":"10.1111","volume":"16","author":[{"given":"S","family":"Georgala","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ac","family":"Katoulis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Georgala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ec","family":"Katoulis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Hatziolou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ng","family":"Stavrianeas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2002,8,28]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"211","article-title":"Early onset pretibial myxedema in the abscence of ophthalmopathy: a morphologic evolution","volume":"58","author":"Omohundro C","year":"1996","journal-title":"Cutis"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-4362.1997.00321.x"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(98)70363-9"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199401000-00001"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(87)90967-3"},{"key":"e_1_2_5_7_2","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1001\/archderm.1986.01660130089033","article-title":"Unusual locations of localized myxedema in Graves's disease","volume":"122","author":"Noppakun N","year":"1986","journal-title":"Arch Dermatol"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.1998.tb02394.x"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.271.24.14567"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12543646"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.80.12.3430"},{"issue":"15","key":"e_1_2_5_12_2","first-page":"31","article-title":"IgA, IgG and C3 deposits in the extra\u2010thyroidal manifestations of autoimmune Graves's disease: their in vitro solubilization by intravenous immunoglobulin","volume":"14","author":"Antonelli A","year":"1996","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1006\/clin.1994.1059"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1997.7.3"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12320948"},{"key":"e_1_2_5_16_2","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1001\/archderm.1981.01650100037024","article-title":"Preradial myxedema in thyroid disease","volume":"117","author":"Worstman J","year":"1981","journal-title":"Arch Dermatol"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1996.6.41"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1994.4.399"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.1468-3083.2002.00567.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1046\/j.1468-3083.2002.00567.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T11:10:56Z","timestamp":1697541056000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1046\/j.1468-3083.2002.00567.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,7]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2002,7]]}},"alternative-id":["10.1046\/j.1468-3083.2002.00567.x"],"URL":"https:\/\/doi.org\/10.1046\/j.1468-3083.2002.00567.x","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,7]]}}}