Cutaneous manifestations of hyperthyroidism - A study of 50 cases from Lahore, Pakistan

Objective: To assess the pattern of cutaneous changes and associated disorders in patients with hyperthyroidism Study Design: Cross-sectional study. Place and Duration of Study: Departments of Dermatology and Thyroid Clinic, Mayo and Jinnah Hospitals, Lahore, during the period of one year from December, 1997 to December, 1998. Subjects and Methods: 50 diagnosed cases of hyperthyroidism (44 females and 6 males of age ranging 21-40 years) were examined in detail for cutaneous changes and associated disorders. Results: Dermatological abnormalities were observed in 96% patients. Common manifestations of hyperthyroidism were altered skin texture in 48 (96%) and increased skin temperature in 46 (92%) patients. Other cutaneous findings included hyperhidrosis in 34(68%), generalized pruritus in 15 (30%), hyperpigmentation in 15 (30%) and pretibial myxedema in 2 (4%) patients. Hair and nail changes were observed in 36 (72%) and 25 (50%) patients, respectively. Other associated autoimmune diseases seen were urticaria in 20 (40%), vitiligo in 12 (24%), alopecia areata in 4 (8%) and systemic lupus erythematosus in 1 (2%) patient. Pustulosis palmoplantaris and xanthelasma were seen in one patient each. Conclusion: Cutaneous examination can provide important clues to the diagnosis of hyperthyroidism.