Skin problems - WARNING photos attached

[Wired123]

Apologies for gruesome photos but my hypothyroid (Hashimoto’s) mother has had skin issues for over a year on both hands and both feet.

Dermatologist keeps trying different high strength creams but they make little difference.

The skin is painful and has small cuts which increase pain. She cannot do basic things like cook or walk due to pain.

Could this be thyroid related? Her last results showed TSH of 4.5 so I’ve convinced GP to increase her dose and will retest in 6 weeks.

Would be keen to see if anyone else has experienced this kind of skin issue and fixed it with T4 increase.

Her sugar levels are pre-diabetic so this could also be a factor.

Any other possible causes and/or solutions would be gratefully received.

[SlowDragon Administrator]

On levothyroxine TSH should be under 2, so she’s very under medicated

How much levothyroxine is she now taking

Does she always get same brand levothyroxine

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements is she currently taking

As she has Hashimoto’s is she on strictly gluten free diet

Recommend getting FULL thyroid and vitamins tested

Ask GP to test vitamins NOW and coeliac blood test if she’s not yet gluten free

[Wired123 in reply to SlowDragon]

Increased from 75 to 100 and she’s starting to feel better already. Will retest at 6 weeks and add in your suggestions.

[SlowDragon Administrator in reply to Wired123]

Come back with vitamin results once you get them

Likely to be low as she was so hypothyroid

[Cooper27]

Have they ever biopsied it? It looks a bit like candida (athlete's foot), but I presume they'll have tried that.

The best description I've heard for eczema is that the only thing we know is that it isn't a steroid cream deficiency... But that doesn't help understand what it is.

There's a useful checklist I downloaded to help figure out the underlying cause for my eczema, and you can try it to work on your mum's:

skinterrupt.com/

[Wired123 in reply to Cooper27]

Yes they have tried biopsy and other dermatology investigations and have not found anything of note. Hence I am thinking perhaps it’s thyroid related as she’s so under medicated and now has increased dose so let’s see.

I’m wondering if anyone else has had such severe issues of skin due to thyroid under treatment and if it resolved by increasing thyroxine.

Otherwise I will have to get her to see a private Dermatologist to get a second opinion.

[Cooper27 in reply to Wired123]

I get pretty bad skin problems, and my legs get very nasty bleeding dermatitis on them if I eat gluten, which is also an intolerance common with hashimotos, so there are other possible causes relating to the disease.

I don't know that a private dermatologist will help where an NHS one hasn't been able to, they would tend to prescribe a steroid cream, and that may treat the symptoms but it won't treat the cause.

[SlowDragon Administrator in reply to Cooper27]

Would agree, with Hashimoto’s, very often skin issues are gluten related

[Wired123 in reply to SlowDragon]

Would a gluten issue show up at age 65 all of a sudden? She’s been hypo for over 30 years but this skin issue only a year or so.

From existing replies it doesn’t look like resolving her thyroid meds is going to fix this.

Will suggest gluten free trial as well, not that she will ever listen!

[SlowDragon Administrator in reply to Wired123]

Obviously she need vitamin D, folate, ferritin and B12 levels tested

What vitamin supplements is she taking

Has she had bloods retested after dose increase in levothyroxine….she may need further increase

Does she always get same brand levothyroxine at each prescription

Bloods should be retested 6-8 weeks after any dose change or brand change in levothyroxine

Aim is to bring TSH down to around one. Most important results are ALWAYS ft3 followed by Ft4

[helvella]

Whenever there is a skin issue, I think about posting a link to Dermnet NZ. Their library of photos covers an awful lot of skin issues - and, in particular, they have obviously tried to include multiple photographs to illustrate the range of possible presentations.

As it happens, when I went to the site, my browser opened the site on a page about Palmar Erythema. That doesn't look quite right to me, but would be something to consider and decide on.

dermnetnz.org/topics/palmar...

Even modest hypothyroidism had an impact on my skin - dryness and hard, uncomfortable elbows which, although mild, started to crack very slightly. Anyone with thyroid issues is all too likely to have any of a wide range of skin problems.

[Wired123 in reply to helvella]

Thanks will have a look at that site.

[jimh111]

Hypothyoid is unlikely to cause localised problems but it will impede tissue repair and cause dry skin, so it's important to be adequately medicated. Hypothyroidism also causes vitamin A deficiency resulting in carotenemia (yellow skin on palms) in severe cases. Vitamin A is needed for tissue repair so I would supplement just to make sure she is not deficient.

[Wired123 in reply to jimh111]

Thanks Vit A is a good idea, can’t do much harm if supplement for a couple of months to aid the repair.

[Anthea55 in reply to Wired123]

I was wondering about vitamin A. Years ago my son and his wife came to visit. She had a rash on her hands which wasn't responding to anything she had tried. I happened to have a vitamin A cream which I gave her to take away and try - it worked.

I just googled for vitamin A deficiency and one of the things that came up was this

healthline.com/nutrition/vi...

A short way down there's heading '1. Dry skin' with a picture - could be that?

Worth a try maybe. Possibly cream if you can find one.

[Wired123 in reply to Anthea55]

Thanks very much

[jimh111 in reply to Anthea55]

Yes, or even cod liver oil is good although I feel the capsules should be banned so todays kids get to suffer like we did! The taste still comes back when I think of it.

[Ellie-Louise]

I used B12 cream for my eczema and it cleared it up after using it every night before bed. It took a while but did go. I also had very bad pompholyx on my hands that was extremely embarrassing, B12 cleared that up too.

Nowadays I only have a small recurring patch now and treat it with this cream. It takes the itching off and clears up very quickly.Bought it on Amazon btw.

[Jeepster2023]

This looks like what I'm going through. I also have it on my shines and lower back Done biopsy last week. GP don't have a clue as to what it is. I have been dealing with it since August. I was diagnosed with underactive thyroid in May of 2022 and am on synthroid 75mg. I have been through 4 rounds of antibiotics ,antibiotic shot, antifungal medication, steroids and a dozen creams and nothing has helped . Dermatologist didn't know what it was either.