Note that pretibial myxedema can occur at any time in thyroid disease and sometimes there is no alteration in thyroid function at all or even low function. In hypothyroidism there is a slow metabolic rate due to alteration of glandular function. The slowed metabolic function results in insidious onset of tiredness, fatigue, leg cramps, etc. The skin is cold, dry and pale. The skin colour can be yellow due to alteration in Vitamin A metabolism - carotenemia.
Hair is lost all over - scalp, groin, even lateral eyebrows.
Nails grow slowly and are brittle and thick. The skin is swollen, dry, pale and waxy. One can slowly develop a broad nose, swollen lips and puffy eyelids. Wounds heal slowly. Skin Changes in Hypothyroidism Pale, cold, scaly, wrinkled skin Coarse, dry scalp and hair Absence of sweating Hair loss - scalp groin, lateral eyebrows, etc.