Myxedema Coma versus Pretibial Myxedema - USMLE Forums
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Old 02-15-2013
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Thyroid Myxedema Coma versus Pretibial Myxedema

What is the difference between pretibial myxedema and myxedema (coma and psychosis)caused by hypothyroidism ?? I am always confused on it
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Old 02-15-2013
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Pretibial Myxedema: is seen Grave's disease (Hyperthyroidism), waxy edematous skin lesion along the tibia.

Myxedema coma: is a severe hypothyroidism leading to decreased mental status, hypothermia, and other symptoms related to slowing of function in multiple organs. It is a medical emergency with a high mortality rate.

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The term myxedema is often used interchangeably with severe hypothyroidism.

Myxedema coma is a life-threatening form of untreated hypothyroidism with physiological decompensation. The condition occurs in patients with long-standing, untreated hypothyroidism and is usually precipitated by a secondary insult, such as climate-induced hypothermia, infection, or another systemic condition, or drug therapy. Patients with myxedema coma have changes in their mental status, including lethargy, stupor, delirium, or coma.

Myxedema psychosis A chronically under-active thyroid can lead to slowly progressive dementia, delirium, and in extreme cases to hallucinations, coma, or psychosis, particularly in the elderly.


Myxedema also refers to 2 different dermatologic conditions:

Pretibial Myxedema is a localized dermopathy due to lymphocyte infiltration of the dermis leading to redness and thickening giving it peau d'orange (orange peel) appearance most commonly seen in Graves’ disease but can occur in other hyperthyroid states.

Hypothyroid myxedema occurs in severe, long-standing hypothyroid states and is caused by the deposition of mucopolysaccharides within the dermis leading to non-pitting edema.
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Last edited by Novobiocin; 02-15-2013 at 05:39 PM.
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Old 11-26-2013
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Quote:
Originally Posted by Novobiocin View Post
The term myxedema is often used interchangeably with severe hypothyroidism.

Myxedema coma is a life-threatening form of untreated hypothyroidism with physiological decompensation. The condition occurs in patients with long-standing, untreated hypothyroidism and is usually precipitated by a secondary insult, such as climate-induced hypothermia, infection, or another systemic condition, or drug therapy. Patients with myxedema coma have changes in their mental status, including lethargy, stupor, delirium, or coma.

Myxedema psychosis A chronically under-active thyroid can lead to slowly progressive dementia, delirium, and in extreme cases to hallucinations, coma, or psychosis, particularly in the elderly.


Myxedema also refers to 2 different dermatologic conditions:

Pretibial Myxedema is a localized dermopathy due to lymphocyte infiltration of the dermis leading to redness and thickening giving it peau d'orange (orange peel) appearance most commonly seen in Graves’ disease but can occur in other hyperthyroid states.

Hypothyroid myxedema occurs in severe, long-standing hypothyroid states and is caused by the deposition of mucopolysaccharides within the dermis leading to non-pitting edema.
Bro I just saw on ur profile that u have given step 2 before step 1, and I was thinking the same to go for step 2 ck before step 1 as my clinical knowledge is fresh, So is it a good idea? and can you plz tell me your step 2 ck score. thanks
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Old 12-16-2013
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Originally Posted by dr.ali2011 View Post
Bro I just saw on ur profile that u have given step 2 before step 1, and I was thinking the same to go for step 2 ck before step 1 as my clinical knowledge is fresh, So is it a good idea? and can you plz tell me your step 2 ck score. thanks
I don't recommend taking Step 2 before Step 1 if you are a fresh graduate.
However, if you have been out of touch with basic sciences and doing clinical practice for years then only taking Step 2 before Step 1 is a good way to get back to learning for USMLE. I scored 250+ on step 2 CK.
Hope this helps.
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