Elephantiasic pretibial myxedema

Grave's disease is an autoimmune disease of thyroid gland and pretibial myxedema occurs in 4% of these patients. We present a 50-year-old man with Grave's disease who was referred with nonpitting, edematous, erythematous plaques on legs and feet that became elephantiasic. Biopsy of skin revealed granular material deposition in dermis with splitting of collagen fibers. This is a rare presentation of pretibial myxedema that presented in this case