CUTANEOUS MANIFESTATIONS OF

THYROID DISEASE

DR. FARID-UR-REHMAN
FCPS (Derm)
Professor & HOD
Dermatology Deptt, FUMC
Cutaneous Features of Hyperthyroidism

SKIN
• Increased skin temperature
• Palmar erythema, facial flushing
• Increased sweating
• Soft, smooth, velvety
• Pruritus
• Hyperpigmentation
• Pre-tibial myxoedema
NAILS
• Fast nail growth
• Soft nails, koilonychia
• Distal onycholysis
• Thyroid acropachy

HAIRS
• Fine, thin hairs
DIAMOND’S TRIAD
THYROID ACROPACHY
In Grave’s disease:
• Clubbing
• Soft tissue swelling
• With periosteal new
bone formation
PRE-TIBIAL
MYXEDEMA
PRE-TIBIAL
MYXEDEMA
 Cutaneous Features of
Hypothyroidism
SKIN
• Pale, cold, scaly and wrinkled skin
• Absence of sweating
• Xerosis, itch
• Ivory-yellow skin colour
• Puffy oedema of hands, face and eye lids
• Palmoplantar keratoderma
• Purpura and ecchymoses
• Delayed wound healing
• Xanthomatosis ( secondary to
hyperlipidaemia )
NAILS
• Brittle and striated nails
• Slow nail growth

HAIRS
• Coarse, sparse scalp hairs
• Loss of pubic, axillary, and facial hairs
• Loss of lateral eyebrows
TYPICAL FACIES HYPOTHYROIDISM
GENERALIZED
PRURITUS
ASSOCIATIONS
MELASMA
ALOPECIA AREATA
VITILIGO
DERMOGRAPHISM