Prevalence of Skin Manifestations in Thyroid Disorders

Abstract

The skin, hair, and nails are strongly influenced by thyroid hormone activity, so disturbances in thyroid function frequently translate into a wide range of dermatological signs. This cross-sectional study set out to determine how often such skin, hair, and nail changes occur among patients with thyroid disease and to examine whether these changes track with the type of thyroid disorder, patient age, or sex. Fifty consecutive patients with a diagnosis of hypothyroidism or hyperthyroidism were enrolled; individuals under 18 years of age, pregnant or lactating women, and anyone with a separate known endocrine disorder were not eligible. Data were gathered through a structured questionnaire addressing demographic characteristics, thyroid disease category, dermatological findings, and personal and family medical history, and associations were tested using the chi-square test, with a p-value below 0.05 taken as significant. Participants were predominantly older (44% aged ≥46 years) and female (64%), and hypothyroidism accounted for 60% of cases versus 40% for hyperthyroidism. Pruritus was the single most common complaint overall (70%), followed by brittle nails (64%) and hair loss (62%). Within the hypothyroid group, cold intolerance and periorbital puffiness topped the list (96.7% each), with rough, dry skin and dry, brittle hair close behind (93.3% each), then scalp hair loss (90%) and itching (86.7%). Among hyperthyroid patients, excessive sweating, heat intolerance, and facial or chest flushing were each present in 95% of cases. Several dermatological findings — rough dry skin, pale or yellowish skin, flushing, skin color change, temperature intolerance, excessive sweating, scalp hair loss, eyebrow loss, dry brittle hair, itching, facial or periorbital swelling, and finger clubbing — differed significantly by thyroid disease type (p<0.05), and several findings also varied significantly by age and by sex. Overall, hypothyroidism and hyperthyroidism produce distinct, recognizable patterns of skin, hair, and nail involvement, and attention to these signs can support earlier identification of thyroid dysfunction and more complete patient evaluation.