Hypothyroid Nails:
Increasing our identification of these diseases coexisting together will help improve our understanding and result in the development of novel therapies to help combat both thyroid disease and urticaria. Plummer was the first to describe Plummer’s nails when he drew attention to this manifestation of onycholysis in patients with hyperthyroidism (75). Thyroid dermopathy has proven to be a manifestation of thyroid disease that can point a physician to hyperthyroidism.
SJ is the senior author on the paper, and helped supervise and guide both BC and AC, as well as help with editing and writing the abstract and introduction. All authors contributed to the article and approved the submitted version. There have been several cases of onycholysis as a presenting symptom of hyperthyroidism.
While AA and PA have been linked to Graves’ disease, the mechanism is still unknown, paving the way for further investigation into this fascinating association. Treatment for these conditions varies widely in the literature and will continue to evolve as more knowledge is gained from treating these conditions. Levothyroxine is the first line of treatment to replace the lack of thyroxine in the body.
The formal name for this is Paronychia and it is a very very hallmark sign of hypothyroidism, meaning low thyroid condition. This type of symptom nutritionally is often times also linked to a protein deficiency. Interestingly enough, one of the major forms of amino acids (amino acids are the building blocks for protein) responsible for helping thyroid function is Tyrosine. Often times we will see a protein deficiency, learn more here and particularly Tyrosine deficiency, in patients that have low level of thyroid and it will present in the cuticles looking just like this, called Paronychia. Optimizing your thyroid levels with thyroid hormone replacement medication is usually the first step in minimizing symptoms. The good news is that managing hypothyroidism with thyroid hormone replacement medication usually reverses most nail changes.
The main treatment for hypothyroidism is hormone replacement therapy. People with too little thyroid hormone (hypothyroidism) often struggle with symptoms of dry skin, brittle nails, and hair thinning. Perhaps the primary reason this occurs is that every system in your body slows down when there is not enough thyroid hormone.
Besides dry skin, those with hypothyroidism may experience changes in their skin coloring. However, some skin conditions are severe and need additional treatments. It helps protect your body by via keeping germs out, holding body fluids in to prevent dehydration, and maintaining your body temperature. Those with untreated or undertreated hypothyroidism may notice changes in their skin.
The majority of patients respond well to levothyroxine, and they usually take this medication for life. Seek medical attention right away if you are experiencing symptoms of myxedema coma, such as severe fatigue or extreme cold intolerance. The association between thyroid function and peripheral neuropathy isn’t click here for info fully understood. However, researchers believe that hypothyroidism leads to fluid retention, resulting in swollen tissues. The symptoms of hypothyroidism can be non-specific or attributed to other factors, like stress and aging. The appropriate dosage of levothyroxine raises thyroxine to ideal levels.
These case reports showed a predominance of middle-age to elderly patients with worsening keratoderma on the soles compared to the palms (131). Typical treatment of palmoplantar keratoderma involves the use of keratolytics, topical or systemic retinoids, and in some cases corticosteroids (132). In each of the reported cases of acquired palmoplantar keratoderma due to hypothyroidism, these standard treatments were not effective. Overall, the etiology of why this condition develops is unclear but may be related to dysregulation of lipids in the stratum corneum (131). Hyperthyroidism has several causes (including, most commonly, Graves’ disease), followed by other causes such as thyroiditis, toxic multinodular goiter, toxic adenoma, and iatrogenic thyroid hormone use (18). Thyroid hormone is tightly regulated in the blood stream via the hypothalamic-pituitary-thyroid (HPT) axis (1).
This would be a unique presentation for someone who was clinically hypothyroid with Graves’ disease presenting with onycholysis. In a 2013 paper of three case reports, jaundice was described as the presenting skin finding of Graves’ disease. She previously had a distant history of a goiter treated with partial thyroidectomy with resultant hypothyroidism requiring levothyroxine therapy.
The most common cause of congenital hypothyroidism is thyroid dysgenesis. The thyroid gland is either missing, malformed, or severely underdeveloped in this condition. People (and their healthcare providers) begin to suspect an underactive thyroid gland only by looking at symptoms in their totality. Symptoms of hypothyroidism can affect various parts of the body, including the hands. Hand-related symptoms may include cold hands, joint pain, and tingling.
While radioactive iodine therapy has been shown to be effective, total thyroidectomy has been used as another tool to manage chronic spontaneous urticaria in patients with Graves’ disease. She had previously been given multiple medications for treatment including oral corticosteroids and anti-histamines as well as levothyroxine, with little effect. She underwent total thyroidectomy with complete resolution of urticaria and angioedema three days post operatively (115).