Severe pretibial myxedema.

Although pretibial myxedema (PTM) occurs in 4.3% of patients with Graves's disease, the most severe variant, elephantiasis nostras verrucosa, is found in less than 1% of cases. The most frequent location of infiltration is the lower extremities, especially the pretibial areas and on the dorsum of the foot. The authors report one of the most severe cases of elephantiasis nostras verrucosa, following radioactive iodine therapy.