Antecubital mucinous edema

　　Currently, it is believed that the disease has the same characteristics as exophthalmos in hyperthyroidism, which is a manifestation of an autoimmune disease, and the evidence includes:

　　1. This disease is almost always accompanied by diffuse hyperthyroidism, which has been considered an autoimmune disease.

　　2. In patients with diffuse hyperthyroidism, hyperthyroidism, exophthalmos, and pretibial myxedema, LATS (long-acting thyroid stimulating factor) may be found in serum.

　　2. LATS also exists in pretibial myxedema fluid and biopsy specimens.

　　3. LATS participates in activating lymphocytes to promote the proliferation of fibroblasts and produce a large amount of mucin.

　　Pretibial myxedema often occurs with hyperthyroidism and exophthalmos, and can cause muscle relaxation and weakness, bradycardia, cardiac enlargement, pericardial effusion and other diseases, which seriously affects the health of patients, so it is necessary to treat it in time.

　　What are the typical symptoms of pretibial myxedema? The most common is in the pretibial area, starting on one side, then extending to involve both lower leg extensors, usually symmetrical distribution, a few also seen in hands, arms and face, occasionally seen in the trunk, damage is round, oval or irregularly round, swelling firm, pressure without indentation, clear boundary, waxy semi-transparent to rose or light red, sometimes with brown or brown-black, surface uneven, large pores can be orange peel-like, locally often with increased sweating and abundant, thick, black and shiny vellus hair, self-perception may be accompanied by itching or sensation of ants crawling.

　　This disease often occurs with hyperthyroidism and exophthalmos, thyroid acropathy is not common, its characteristics are: metatarsal and distal long bone periostitis, soft tissue swelling above, clinical manifestations are knuckle-like fingers and toes.

　　How to prevent pretibial myxedema? Briefly described as follows:

　　1. Correct iodine deficiency

　　The etiology of endemic cretinism is mainly due to iodine deficiency, and correcting iodine deficiency can effectively prevent the occurrence of the disease.

　　2. Rational nutrition

　　Malnutrition can cause thyroid shrinkage, hypothyroidism, thus affecting children's physical and intellectual levels.

　　3. Early diagnosis and early treatment can have a positive preventive effect.

　　What examinations should be done for pretibial myxedema? Briefly described as follows:

　　1. Serological examination

　　Serum LATS titer is elevated,

　　2. Thyroid function test

　　Including basal metabolic rate, radioactive 131I and T3, often suggesting hyperthyroidism.

　　3. Tissue Pathology Examination

　　There is a large accumulation of mucoprotein in the dermis, especially in the middle and lower 1/3, resulting in明显 thickening of the dermis. Mucoprotein causes widespread splitting of collagen fiber bundles, and under an electron microscope, it can be seen that there are star-shaped expanded active fibroblasts in the mucoprotein area.

　　The dietary principles for pretibial myxedema are briefly described as follows:

　　One, Eat

　　1. Eat easily dehydrated foods.

　　2. Eat foods that enhance immunity

　　3. Eat easily digestible foods.

　　Two, Avoid

　　1. Avoid eating preserved foods, such as salted pork, salted eggs, and salted fish.

　　2. Avoid eating foods that produce gas, such as onions, sweet potatoes, and soybeans.

　　3. Avoid eating indigestible foods, such as glutinous rice, rice cakes, and meatbuns.

　　Three, Recommended Diet

　　1. Corn Silk and White Grass Root Drink

　　50 grams of corn silk and white grass root, boiled together into a soup, add appropriate amount of sugar and take in divided doses.

　　2. Red Bean Carp Soup

　　60 grams of red bean, 1 carp (without intestines), 10 grams of ginger, cooked together into a soup, without salt, eat the fish and drink the soup.

　　3. Astragalus Lean Pork Soup

　　60 grams of Astragalus, an appropriate amount of lean pork, boiled together into a soup, without salt, eat the meat and drink the soup.

　　A brief description of the treatment methods for pretibial myxedema:

　　1. Intradermal Injection of Triamcinolone (Kenalog) Therapy

　　Dilute the Triamcinolone suspension with physiological saline to a solution of 5mg/ml, and inject intradermally, 1ml per site, not exceeding a total dose of 40mg per time, once every 3-4 weeks; some advocate injecting an equal amount of hyaluronidase (1500U/ml physiological saline) along with the Triamcinolone suspension intradermally, which can completely regress the damage, but recurrence is common after stopping the medication for several months, and this therapy is still effective for recurrent cases.

　　2. Antitumor Drug Therapy

　　(1) Busulfan (CB1248), 0.1-0.3mg/kg daily, taken in 2-4 doses, with a total dose of about 400-500mg.

　　(2) Cyclophosphamide, initially taken at 200mg/d, gradually reduced to 50mg/d, with a total dose of about 8g.