Treatment of Localized Myxoedema - DMSO

[Thoth]

Treatment of Localized Myxoedema SIR, -Like Drs. R. Hall, G. Holti, and C. J. Stevenson (4 December, p. 1368) I was surprised to find no mention of the long- acting thyroid stimulator (L. A. T. S. ) in your leading article on localized myxoedema (13 November, p. 1138), but I cannot go all the way with them. I have tried systemic and local corticoids (by inunction and multiple acupuncture) with and without, usually with- out, success and I have scored one success with a polythene bag worn on one leg at night without a local corticoid. I have used x-ray therapy, ultra-violet radiation, dia- thermy over Miller's bandages, hyaluronidase by multiple acupuncture and by infusion into the femoral artery, and every available analogue of thyroxine both locally and systemically. None of these methods has been consistently successful. On the other hand, I have seen several spontaneous recoveries. Last month at the Royal Society of Medicine I showed a patient with Hashimoto's disease, exophthalmos, acropachy, and very severe localized myxoedema. who had also a very high titre of L. A. T. S. in her plasma. The leg more severely affected had been treated by all the above remedies without result. I decided to treat it by the local application of dimethyl sulphoxide. This substance is an industrial solvent known for a century. It has been used in various disorders of the skin and has been regarded as non-toxic. It easily penetrates the skin and is a solvent of mucopolysaccharides. It therefore occurred to me that it might be effective in localized myxoedema, a condition in which, I believe, it has not previously been tried. In the patient described the results were highly satisfactory. Unfortunately it has recently been reported that dimethyl sulphoxide causes damage to the eyes of rabbits but not of other animals tested, and no detriment has occurred in monkeys or men. Nevertheless, I have thought it wise, despite the protests of the patient, to discontinue the experiment. It may be found that dimethyl sulphoxide is harmless to man. In that event it may prove to be by itself, as in my solitary case, effective in localized myxoedema. It may also prove to be an effective vehicle for the passage through the skin of other theoretically possible remedies such as hyaluronidase or corticosteroids. It seems unlikely that this is the answer to the problem of localized myxoedema. It may prove an effective temporary remedy simply because it dissolves mucopoly- saccharides. Experience of other occasionally successful remedies suggests that it may not always work. We are left with a problem more important than the occasional relief of the occasional patient. Why does it happen anyway ? -I am, etc. , RAYMOND GREENE. Department of Endocrinology, New End Hospital, London N. W.3.

https://sci-hub.se/10.1136/bmj.1.5480.167-a

 

[Peater]

Wow. Great find @Thoth !

 

[xeliex]

Oh, that's DMSO, sweet.