A Rare Triad in Thyroid Autoimmunity: Case Report of Two Patients with Thyroid-associated Orbitopathy, Dermopathy, and Acropachy

Background:The triad of thyroid-associated orbitopathy (TAO), thyroid dermopathy, and thyroid acropachy is an extremely rare manifestation of autoimmune thyroid disease, with a prevalence of less than 1%.While this triad is typically seen in Graves' disease, its occurrence in hypothyroid patients is exceedingly uncommon.Case description: We present two cases of this rare triad: One in a hypothyroid female with Hashimoto's thyroiditis and the other in a male with longstanding Graves' disease.Conclusion: These cases highlight the rare triad of TAO with thyroid dermopathy and acropachy in the spectrum of autoimmune thyroid disorders-hypothyroidism and Graves' disease.Clinical significance: These cases highlight the importance of vigilance for extrathyroidal manifestations, even in hypothyroid states.