Acropachy

Acropachy is a rare, but severe, manifestation of autoimmune thyroid disease, including both Graves' disease and Hashimoto's thyroiditis. It is characterized by clubbing of the fingers and toes, swelling of the digits and hands, and thickening of the skin.

Symptoms

The primary symptoms of acropachy are clubbing of the fingers and toes, swelling of the digits and hands, and thickening of the skin. These symptoms are often accompanied by changes in the nails, such as onycholysis (separation of the nail from the nail bed), nail bed inflammation, and pitting of the nails.

Causes

Acropachy is associated with autoimmune thyroid diseases, including Graves' disease and Hashimoto's thyroiditis. It is thought to be caused by an immune response that targets the connective tissue in the skin and nails.

Diagnosis

Diagnosis of acropachy is based on the presence of characteristic symptoms and a history of autoimmune thyroid disease. Imaging studies such as X-rays may be used to confirm the diagnosis.

Treatment

Treatment of acropachy involves managing the underlying thyroid disease. This may include medication to regulate thyroid hormone levels, radioactive iodine therapy, or surgery to remove the thyroid gland. In some cases, corticosteroids may be used to reduce inflammation and swelling.

Prognosis

The prognosis for individuals with acropachy is generally good, especially if the underlying thyroid disease is well-managed. However, the changes to the skin and nails may be permanent.

See also

• Graves' disease
• Hashimoto's thyroiditis
• Clubbing (medical)
• Onycholysis

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