Pretibial myxedema is a localized dermopathy seen in patients with past or present hyperthyroidism. Massive intradermal deposition of mucin (acid mucopolysaccharide) produces the classic indurated nodules or plaques on the anterior lower legs. Most patients have elevated levels of LATS in their serum; however, this appears to be a marker for the disease, rather than a cause. Mild pretibial myxedema requires no treatment. Topical, intralesional or systemic steroids may be useful in severe cases.