Necrobiosis lipoidica arising on an old burn scar in a patient with Hashimoto's thyroiditis

[helvella]

Every so often, a peculiar observation is reported. In this case, the original injury followed so many years later by a goitre, is probably, if not rare, at least unusual. And for the effects reported to have occurred might be unusual even within that.

A classic situation which is likely to see this not being listed as a possible result of Hashimoto's thyroiditis. After all, there will be a huge majority who do NOT get this.

Necrobiosis lipoidica arising on an old burn scar in a patient with Hashimoto's thyroiditis

MayuSatoToshiyukiYamamoto

doi.org/10.1016/j.abd.2020.... rights and content

Under a Creative Commons license

Open access

Dear Editor,

A 58-year-old female visited our department, complaining of asymptomatic skin lesions on the lower legs, which had appeared two years previously. She did not have diabetes; however, she had been diagnosed as having a goiter at almost the same time as when the skin lesions began and were under follow-up. Physical examination showed several well-circumscribed waxy brownish infiltrated plaques with elevated borders on the bilateral shins (Fig. 1A and 1B). Initial lesion arose on a burn scar, which had originally been caused by a Japanese electric foot warmer, that is used in the bed in winter. Thereafter, similar lesions were increased in number in the surrounding areas and spread to another lower leg.

If at all interested, follow this link and you can see the whole article. It really needs you to have the images available to fully appreciate.

sciencedirect.com/science/a...

[greygoose]

Thereafter, similar lesions were increased in number in the surrounding areas and spread to another lower leg.

How many legs has she got? 🤣🤣🤣

Sorry, couldn't resist.

[helvella Administrator Thyroid UK in reply to greygoose]

It rather implies she might have some upper legs - or even middle legs?

Perhaps she was a spider?

[tattybogle in reply to greygoose]

it only said 'a 58 yr old female ' ..... it didn't specify 'what'

Spider perhaps ?

[RedApple Administrator in reply to tattybogle]

Can spiders live that long? And can they get a goitre? 🤣

[tattybogle in reply to RedApple]

i reckon so ... i've known some that would appear to fit the bill.

[helvella Administrator Thyroid UK in reply to RedApple]

An excellent question. Wiki says:

Number 16 (c. 1973 – 2016), also known as #16, was a wild female trapdoor spider (Gaius villosus, family Idiopidae) that lived in North Bungulla Reserve near Tammin, Western Australia. She died in 2016, at an estimated age of 43 years, and is the longest-lived spider recorded to date. Number 16 did not die of old age, but was most likely killed by a parasitic wasp sting.

So 58 is probably a bit too old.

Arthropods (hence arachnids) seem to use sesquiterpenoid juvenile hormone (JH) where vertebrates use thyroid hormone. But thyroid hormones themselves appears to have a similar effect on arthropods.

Comparing thyroid and insect hormone signaling

academic.oup.com/icb/articl...

[RedApple Administrator in reply to helvella]

I should have guessed you'd find the answers to my silly questions! 🤣🤣🤣

[helvella Administrator Thyroid UK in reply to RedApple]

Even the silliest question can trigger a moment of "I wonder if...". And a realisation of utter ignorance in numerous directions.

[TSH110 in reply to helvella]

Love it!

[TSH110]

I’ll stick to bed socks!