Conundrums of Hypothyroidism

A 46-year-old female presented with symptoms including severe hair loss, skin dryness, swelling, tingling numbness, and difficulty swallowing, among others. Examination revealed loss of eyebrows, alopecia on the scalp, and skin lesions. A differential diagnosis considered several conditions, but laboratory tests indicated primary hypothyroidism, with low T3 and T4 and elevated TSH levels. Histopathology showed mucin deposition and a non-scarring alopecia pattern. The patient was diagnosed with hypothyroidism and treated with levothyroxine, hematinics, multivitamins, calcium supplements, and emollients.