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  • Title: Elephantiasic pretibial myxedema: a novel treatment for an uncommon disorder.
    Author: Susser WS, Heermans AG, Chapman MS, Baughman RD.
    Journal: J Am Acad Dermatol; 2002 May; 46(5):723-6. PubMed ID: 12004314.
    Abstract:
    Pretibial myxedema is a known manifestation of Graves' disease. Much less common is the elephantiasis nostras variant, which is often refractory to treatment. We therefore elected to try a new therapy, often used for the management of chronic lymphedema, called complete decongestive physiotherapy. After 6 weeks of intensive treatment, our patient lost 37 pounds and had reduced her edema volume by 47%. Her skin softened with decreased lymph seepage and she became mobile for the first time in years. At a 2-year follow-up visit, she exhibited sustained improvement. This case demonstrates that complete decongestive physiotherapy can provide effective, long-term control of this disease process. We suggest that complete decongestive physiotherapy be considered in patients with severe forms of pretibial myxedema, as well as those with refractory lymphedema.
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