This may be as a result of the abnormal level of thyroid hormone, or a consequence of an underlying condition. Thyrotoxicosis results in an increase in metabolic rate. Graves disease can be associated with vitiligo . This may appear before, during or after the thyrotoxic state. It may also be associated with an underactive thyroid.
Pretibial myxoedema presents with a lumpy appearance over the shins.
The skin may be discoloured pink or purple, with prominent hair follicles. It may have a warty appearance. It is thought to be caused by autoantibodies - these are the mistaken immune cells which cause Graves disease. The result is a thickened and inelastic skin which is filled with excessive hyaluronic acid and chondroitin sulphate.