The extrathyroidal manifestations of GD, i.e. GO and dermopathy, are due to immunologically mediated activation of TSHR expressing fibroblasts in the extra ocular muscles and skin, proliferation of connective and adipose tissue with accumulation of glycosaminoglycans, leading to the trapping of water and edema [22–29]. The gene discussed is TSHR; the disease is Abnormality of the skin.