Preliminary experience of the use of high-resolution skin ultrasound for the evaluation of extrathyroideal manifestations of Graves’ disease and response to UVA-1 phototherapy

Graves' orbitopathy (GO) and pre-tibial mixedema (PTM) are autoimmune manifestation sharing the same etiology and histopathology, a chronic course and a frustrating treatment. Current management include topical and systemic corticosteroid as first line therapy, whereas cyclosporine, surgery and orbital radiotherapy are indicated for severe GO with variable results and mostly temporary remissions. In particular, keratopath and photophobia, due to exophthalmos and eyelid retraction, impaired eye mobility and diplopia due to the compression of optic nerve and extra-ocular muscles are usually minimally modified, as well as leg plaques/nodules and lymphoedema.