Psoriasiform lesions and abscesses as initial manifestations of severe hypothyroidism in a previously healthy 15-year-old girl.

Hypothyroidism is associated with many characteristic cutaneous manifestations; however, to the best of our knowledge, it has not previously been linked to psoriasiform lesions or multiple abscesses. We describe a previously healthy 15-year-old girl with psoriasiform lesions, abscesses, and extremely severe hypothyroidism, all presenting simultaneously. The pathophysiology of the connection is unclear, but several hypotheses are discussed. The temporal relationship of these conditions and the significant improvement of the skin lesions upon normalization of T4 levels following initiation of thyroid supplementation illustrate a direct association. It is probable that the extreme severity of hypothyroidism in our patient is implicated in the etiology of these skin lesions. This unique case illustrates that novel cutaneous manifestations may sometimes act as an early presenting sign of hypothyroidism and may be associated with more severe forms of the disorder.