Graves disease and rash on leg

[Josephine05]

Hello.  My husband has hyperthyroid (together with graves disease).  He has the bulging eyes etc.  His endocronlogist always looks on his legs for rashes.  Hes never had a rash before so he never even bothered asking the doctor what the reason for looking out for it.  Tonight Ive noticed rashes spreading all over his legs.  My question is 1.what is this a sign of? 2.does he need medication for it?  thanks for your help!

P.S. Im new here and found this site from a search.  Any suggestions for help on this would be really appreciated. thanks!

[Mark Lupo, M.D.]

The classic rash on the legs of patients with Graves Disease is pre-tibial (ie, in the area of the shins) myxedema.  This is the same process (we think) as the eye inflammation so if he has the eye disease, this is a possibility.  There may be another cause for the rash - a biopsy by a dermatologist may be nessary to confirm the diagnosis.  Steroids may help (in the same way they decrease the inflammation around the eyes).  

If he smokes, please ask him to stop now as this greatly increases the eye disease.  As the thyroid is treated these inflammations improve in most cases.

[Josephine05]

Thank you doctor for replying.  My husband DOES NOT smoke (never ever did).  What are the side affects of steriods?  I heard that steriods inhibits the immune system.  My husband will go to a dermotologist regarding the rash on knee and on calf (besides the shin).
My husband was never tested for thyroid peroxidase or trab and I was wondering what they are?

thank you again!

[Mark Lupo, M.D.]

Steroids do suppress the immune system - that is the reason they decrease inflammation.  Generally steroids are avoided unless absolutely necessary - see what the evaluation shows before considering the steroids.  Glad he does not smoke.  The distribution of the rash is not classic for Graves related rash.  

The TPO and TRAB are antibodies that reflect immune system activity against the thyroid -- usually elevated in Graves Disease.