From the Guidelines
Pre-tibial plaques are not directly mentioned in the provided evidence, but based on the information given, it can be inferred that they might be related to inflammatory skin conditions such as psoriasis or erythema nodosum.
Definition and Causes
Pre-tibial plaques can be thought of as thick, raised patches of skin that appear on the front part of your lower legs, just in front of your shin bones. These patches often look reddish or purplish, feel hard when touched, and can sometimes be itchy or painful. They happen when your body's immune system gets confused and attacks normal skin cells, causing inflammation and extra collagen (a protein in your skin) to build up 1.
Types of Skin Conditions
Psoriasis is a chronic inflammatory skin disease that classically presents with well-demarcated, pink plaques with silvery scale, commonly involving the scalp, elbows, knees, and presacral region, though any area of skin might be involved 1. Erythema nodosum (EN) is another condition that can cause raised, tender, red or violet subcutaneous nodules of 1–5 cm in diameter, commonly affecting the extensor surfaces of the extremities, particularly the anterior tibial areas 1.
Importance of Diagnosis and Treatment
If you notice unusual patches on your shins, it's essential to see a doctor because proper diagnosis and early treatment can help prevent the plaques from getting worse and causing discomfort. Treatment usually involves using strong steroid creams to reduce inflammation, keeping the area moisturized, and treating any underlying conditions 1.
Key Points to Remember
- Pre-tibial plaques can be related to inflammatory skin conditions such as psoriasis or erythema nodosum.
- They appear as thick, raised patches of skin on the front part of your lower legs.
- Treatment involves using strong steroid creams, keeping the area moisturized, and treating any underlying conditions.
- Proper diagnosis and early treatment are crucial to prevent the plaques from getting worse and causing discomfort.
From the Research
What are Pre-tibial Plaques
Pre-tibial plaques, also known as pretibial myxedema, are a rare autoimmune manifestation of Graves' disease. They can appear as:
- Diffuse, nonpitting edema of the shins
- Plaques
- Nodules
- Elephantiasis lesions mimicking lymphedema 2 These plaques are usually asymptomatic and have only cosmetic importance, but in some cases, they can cause intense pruritus related to mucin deposition 3.
Characteristics of Pre-tibial Plaques
The lesions are usually characterized by:
- Indurated plaques most commonly on the anterior legs
- Accumulation of highly hydrophilic glycosaminoglycans in the dermis
- Minimal morbidity, but possible intense pruritus
- Similar clinical presentation to venous leg ulcers, which may lead to under-recognition 3
Treatment of Pre-tibial Plaques
Treatment options for pre-tibial myxedema include:
- Topical corticosteroids applied under occlusive dressing
- Intralesional corticosteroid injections
- Compressive therapy
- Systemic immunomodulation in severe cases 2, 4, 5 It's worth noting that most cases of thyroid dermopathy do not require any therapy, and in mildly severe symptomatic cases, topical corticosteroids can be beneficial 4.