Case series of dermopathy in autoimmune thyroid disease

Graves' disease (GD) is an autoimmune disease that can affect other tissues in addition to the thyroid gland. The clinical manifestations are a result of the impact of TSH receptor antibodies. Depending on the intensity of the immune response, in addition to hyperthyroidism, orbitopathy, dermatopathy and acropachy can also occur. Extrathyroidal manifestations of GD are most often the result of a more pronounced immune response. Dermatopathy is a rare extrathyroidal manifestation, with a prevalence of 0.5-4.3%, and when it occurs, it almost always accompanies orbitopathy (96%) and hyperthyroidism, while it is associated with a severe form of orbitopathy in 13-15% of cases. It is characteristic of long-standing disease and an intense autoimmune response. We present a case series of five patients with dysthyroid dermopathy. Our patients had different thyroid function disorders (hypo/hyperthyroidism), different forms of dermopathy, and varying times of onset during the disease. Association with orbitopathy and high TRAb concentrations were also present in all our patients. The effects of therapy applied for orbitopathy were monitored, which showed a favorable response on dermopathy, especially with the use of tocilizumab in some of our patients.