Hair follicles are sometimes prominent, giving a peau d orange texture. Areas of nonpitting edema may also develop. In the elephantiasic form of PTM, lesions may coalesce to give the entire extremity an enlarged, verruciform appearance. Overlying hyperhidrosis or hypertrichosis may also be present in these cases. Skin - Distribution Lesions characteristically appear on the lateral or anterior aspect of the leg, but may occur on the thigh, shoulders, hands, forehead or any other skin surface.
Lesions often occur in areas of recent or prior trauma or skin graft donor sites.
Cause is unknown. PTM is generally considered a cutaneous manifestation of thyroid disease. Generalized pruritus may be severe with Graves disease. Mucin may appear as individual threads and granules. With extensive deposition of mucin, the collagen fibers are frayed, fragmented and widely separated.