Scleredema Diabeticorum / Escleredema Diabeticorum Scleredema Diabeticorum

Abstract Scleredema diabeticorum is one of the skin disorders associated with diabetes mellitus, characterized by thickening of the deep layers of the dermis, with excessive mucin and collagen deposition, clinically evidenced in hardening of the skin, especially in the upper half of the body. We describe the clinical case of an adult male diabetic who was seen for an indurated cervical lesion which was subsequently diagnosed histopathologically as scleredema diabeticorum. The interest in this case lies in the low prevalence of the condition and its association with poor metabolic control of diabetes. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.1888).

Resumen Dentro de los trastornos cutáneos asociados a la diabetes mellitus, se describe el escleredema diabeticorum el cual se caracteriza por un engrosamiento de las capas profundas de la dermis con depósito excesivo de mucina y colágeno, que produce clínicamente endurecimiento de la piel, principalmente en la mitad superior del cuerpo. Se describe un caso clínico correspondiente a un hombre adulto diabético que consultó por la aparición de una lesión indurada en la región cervical con posterior diagnóstico histopatológico de escleroderma diabeticorum. El interés radica en la baja prevalencia de la condición y su asociación al pobre control metabólico de la diabetes. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.1888).

Ultrasonographic Findings of Scleredema Adultorum of Buschke Involving the Posterior Neck

OBJECTIVE: To describe the clinical and ultrasonographic (US) findings in patients with scleredema adultorum of Buschke, who presented with sclerotic skin on their posterior neck. MATERIALS AND METHODS: After obtaining IRB approval, eight patients with scleredema adultorum of Buschke were enrolled. They underwent US examination of their posterior neck. The diagnoses were confirmed pathologically. The clinical history and US images were evaluated retrospectively. Dermal thickness was compared between the patient group and the age- and sex-matched control group. RESULTS: The patients included seven males and one female with a mean age of 51.5 years. All patients presented with thickening of the skin and/or a palpable mass on the posterior neck. Five (62.5%) of the eight patients showed erythematous discoloration. Six patients (75.0%) had a history of diabetes. The Hemoglobin A1c level was found to be increased in all patients. US images did not show any evidence of a soft tissue mass or infection. The mean dermal thickness in patients (7.01 ± 1.95 mm) was significantly greater than that in the control group (3.08 ± 0.87 mm) (p = 0.001). Multiple strong echogenic spots in the dermis were seen in all patients. Seven patients (87.5%) showed posterior shadowing in the lower dermis. CONCLUSION: When a patient with a history of diabetes presents with a palpable mass or erythematous discoloration of the posterior neck and US shows the following imaging features: 1) no evidence of a soft tissue mass or infection, 2) thickening of the dermis, 3) multiple strong echogenic spots and/or posterior shadowing in the dermis, scleredema adultorum of Buschke should be considered in the differential diagnosis.

The effects of hydrocolloid dressing on neonatal scleredema / 中华护理杂志

Objective To explore the effects of hydrocolloid dressing on neonatal scleredema.Methods Forty patients with neonatal scleredema were enrolled from Department of Neonatology,Affiliated Hospital of Qingdao University from February 2015 to February 2017.The patients were assigned to the experimental group and the control group by random number table with 20 cases in each group.The experimental group was treated with hydrocolloid dressing besides routine comprehensive treatment,and the hydrocolloid dressing was changed every 3～4 d until swelling disappeared.The control group was treated with routine comprehensive treatment.Body temperature,response and swelling of two groups were observed.Results For therapeutic effects between two groups,the total effective rate of the experiment group was 95％,and was significantly better than that of the control group which was 65％(P＜0.05).The recovery time of body temperature and the time of swelling disappear in the experiment group were 38.25±17.33 h and 3.05±1.00 d;while those in the control group were 57.35±32.21 h and 4.65±1.57 d,and the differences were statistically significant(P＜0.05).Conclusion Applying hydrocolloid dressing at swelling site in premature infants can significantly shorten the time of skin swelling,promote body temperature recovery,and improve treatment effects.

A Case of Widespread Scleredema Treated with Cyclosporine and Steroid / 대한피부과학회지

No abstract available.

Scleredema of Buschke associated with difficult-to-control type 2 diabetes mellitus / Escleredema de Buschke associado a diabetes mellitus tipo 2 de difícil controle

SUMMARY Scleredema of Buschke (SB) is a rare disorder of connective tissue characterized by diffuse non-pitting induration of the skin, mainly on the cervical, deltoid and dorsal regions. It is a cutaneous mucinosis of unknown etiology and is associated with bacterial or viral infections, hematological disorders and diabetes mellitus. Histopathological examination shows thickened dermis with wide collagen bundles separated by gaps that correspond to mucopolysaccharide deposits, visualized using special staining. Several treatments are reported in the literature without well-established results. We report a case of SB in a patient with type 2 diabetes mellitus.

RESUMO Escleredema de Buschke (EB) é doença rara do tecido conjuntivo caracterizada por endurecimento difuso e não depressível da pele, principalmente nas regiões cervical, deltoideanas e dorso. Enquadrado no grupo das mucinoses cutâneas, tem etiologia desconhecida e associação com: infecções bacterianas ou virais, alterações hematológicas e diabetes mellitus. O exame histopatológico evidencia derme espessada com fibras colágenas calibrosas separadas por fendas que correspondem a depósito de mucopolissacárides, observados por colorações especiais. Diversos tratamentos são relatados na literatura sem resultados bem definidos. Descrevemos caso de EB em paciente com diabetes mellitus tipo 2.

Scleredema associated with Sjögren’s syndrome

Scleredema adultorum of Buschke is a rare disorder characterized by diffuse swelling and non-pitting induration of the skin usually involving the face, neck, arms and upper trunk. It has been associated with previous infectious diseases, diabetes, paraproteinemia and, more rarely, malignant neoplasms or autoimmune disorders. We report the case of a 30-year-old man who presented with a 2-year history of scleredema. Further investigation led to the diagnosis of primary Sjögren’s syndrome. The association between scleredema and autoimmune disorders has been rarely seen. To our knowledge, there are no other reports describing the association between primary Sjögren’s syndrome and scleredema adultorum of Buschke.

Scleredema diabeticorum: A case report

Scleredema is an uncommon condition of unknown etiology that is characterized by dermal mucinosis and mild sclerosis. It is a symmetrical, diffuse, non-pitting induration of the skin commonly associated with an antecedent febrile illness, diabetes mellitus or paraproteinemia.This is the case of an obese, middle-aged adult female with type 2 diabetes mellitus on oral hypoglycemic medication, who presented with an ill-defined, diffuse erythema and non-pitting induration of the skin on the posterior neck and upper back. It has been estimated that as many as 2.5%-14% of diabetic patients have scleredema. This subset of patients may be under-reported as a consequence of subtle onset and under- recognition. Even lithe prognosis of scleredemadiabeticorum is usually benign, it is important that this condition is recognized since it may have systemic involvement that can lead to complications.

A Case of Scleredema Mimicking Systemic Sclerosis with Hypoalbuminemia Induced by Malabsorption in Alcoholic Chronic Pancreatitis

Scleroderma pathogenesis is the accumulation of extracellular matrix proteins and is a relatively rare connective tissue disorder characterized by skin fibrosis, obliterative vasculopathy, and distinct autoimmune abnormalities. However, many other clinical conditions known collectively as the scleroderma-like syndrome present with substantial skin fibrosis and may be confused with scleroderma, sometimes leading to an incorrect diagnosis. Due to this, early and correct diagnosis is very important to for appropriate treatment available for scleroderma-like syndrome. We report a rare case of scleredema mimicking systemic sclerosis with hypoalbuminemia induced by malabsorption in alcoholic chronic pancreatitis. In this case, the patient's skin sclerosis and joint contracture dramatically improved after high dose steroid theraphy.

A Case of Scleredema Associated with Dermatomyositis

Dermatomyositis (DM) is rare systemic inflammatory disease with typical skin manifestations and muscular involvement. Various skin lesions can accompany this disease, such as Gottron's sign, Heliotrope rash, mechanic's hands, V sign and shawl sign. Scleredema is a very rare skin manifestation in DM. We report a case of DM in a 63-year-old woman, who had scleredema on her thighs. A diagnosis of DM was established by clinical manifestation, elevated muscle enzyme levels, electromyogram measures, and muscle biopsy findings. She was successfully treated with the immunosuppressants methotrexate, cyclosporine, and steroids (low dose).

Coexistence of Scleredema and Acanthosis Nigricans in a Patient with Diabetes Mellitus / 대한피부과학회지

Scleredema and acanthosis nigricans are two distinct dermatological disorders that have been reported in association with insulin resistance. Few reported cases have shown an association between scleredema and acanthosis nigricans. A 53-year-old obese woman with diabetes mellitus presented with a 4-year history of an indurated plaque on the nape and upper mid-back. She also presented with a 20-year history of hyperpigmented, velvety plaques on the neck and both axillae. We report a diabetic patient who developed scleredema and acanthosis nigricans.

A Comparison of the Fraction of Collagen and Elastic Fibers by Image Analysis in Scleredema / 대한피부과학회지

BACKGROUND: Scleredema is a rare connective tissue disorder, characterized by hard and thick skin. It is well known that collagen synthesis is increased in scleredema skin, but there has been no study on the change of elastic fibers. OBJECTIVE: The purpose of this study was to compare the changes of collagen and elastic fibers in scleredema and normal skin. METHODS: We retrospectively evaluated the biopsy specimens of 10 patients diagnosed with scleredema. The control group was selected by matching each scleredema case with same site and similar ages from the biopsy specimens which showed normal dermis. A computerized image analysis system was used to measure the fraction of collagen and elastic fibers and calculate the ratio of elastic fibers to collagen fibers in each group. RESULTS: The skin of scleredema was found to have a significant increase in the percentage of collagen fibers in the dermis compared to the control group. On the other hand, the percentage of elastic fibers was significantly decreased in the scleredema group (p<0.05). CONCLUSION: In contrast to scleroderma which shows an increase in dermal elastic tissue and collagen fibers, we concluded that there is a decrease of elastic fibers in scleredema and that the pathogenesis and molecular involvement are different in the two diseases. we also found that the computerized image analysis system was a useful tool in the measurement of connective tissue components.

Widespread Scleredema Accompanied with a Monoclonal Gammopathy in a Patient with Advanced Ankylosing Spondylitis

Scleredema is a rare cutaneous mucinosis characterized by chronic diffuse induration of the skin, and it is occasionally associated with a monoclonal gammopathy (MG). Ankylosing spondylitis (AS) is noted to be another, chronic systemic inflammatory disorder of the axial skeleton that may accompany the MG. However, patients with scleredema and AS accompanied with a MG have not been reported in the literature. We here report a 40-yr-old man with scleredema and advanced AS accompanied with a MG of IgA-kappa protein. Widespread, long-standing scleredema has been developed over 10 yrs after the initial manifestation of AS. It is uncertain whether the coexistence of scleredema and AS is more than coincidental.

Scleredema in a Child

A rare case of scleredema in a seven year old child is presented. This relevant literature regarding clinical presentation, differential diagnosis and treatment of this disease is also being reviewed.

Scleredema: Clinicopathological Study / 대한피부과학회지

BACKGROUND: Scleredema is a rare connective disorder with unknown etiology. There were no comprehensive studies about the clinical and histopathological features of scleredema in Korea. OBJECTIVE: Our purpose was to find the clinical and pathological features of scleredema. METHODS: The 31 patients with scleredema at our institution over ten years were retrieved. We reviewed medical records, clinical photographs, and histopathology slides of these patients, retrospectively. RESULTS: 1. The male to female ratio was 23:8 (2.9:1). 2. Most of the patients had the insidious onset and chronic localized lesion on the nape and upper back. 3. In sixteen patients (16/31, 51.6%), the diabetes mellitus was accompanied. In these patients, the male predominance (14/16, 87.5%) was significant. 4. The positive staining was in 75%(15/20) of the tissues with alcian blue or mucicarmine staining. 5. In four patients, localized electron beam therapy markedly improved the skin lesion without serious adverse effects. CONCLUSION: A preceding respiratory infection was uncommon. Almost all patients had insidious onset and chronic course. Diabetes mellitus was commonly accompanied, especially in male patients. Electron beam therapy appears to be effective in the treatment of scleredema.

A Case of Scleredema Preceded by Upper Respiratory Infection / 감염

Scleredema is a rare connective tissue disease of unknown etiology and characterized by non-pitting thickening of subcutaneous tissue of the neck, face, head, upper trunk and arms. We present a 28 year-old man with extensive skin changes following upper respiratory infection, who have not any concurrent disorders such as diabetes mellitus. Histopathological findings of skin showed normal epidermis with a widening of spaces between collagen bundles by infiltration of acid mucopolysaccharide in the dermis.

The clinical analysis on 41 cases of scleredema neonatorum combined with pneumorrhagia / 实用儿科临床杂志

0.05), FⅧ, c: 28.9?8.7 vs 43.9?11.4 per cent (P

A case of scleredema

Scleredema is a rare skin disease of unknown cause involving the face, neck, upper portion of the trunk, and proximal upper extremities. The clinical features of it are nonpitting, solid emema or stiffness of the neck, which may be sudden or insidious onset. Preceeding upper respiratory infection or diabetes mellitus have been frequently discribed to be associated with the disease. A monoclonal gammopathy has been frequently observed in patients with scleredema. We present a case of scleredema developed the face, upper portion of the back and shoulder in 16-year-old girl who had a preceeding upper respiratory infection.

Two Case of Scleredema / 대한피부과학회지

We report two cases of scleredema, which appeared as symmetrically nonpitting wooden-like indurated edema on the nape, shoulder, and upper and mid portion of back in a 49-year-old woman and a 72-year-old man, associated with long standing diabetes mellitus for the past 5 and 14 years respectively. The scleredema showed no tendency to resolve. Acid mucopolysaccharides were demonstrated histochemically between collagen bundles in the dermis, especially in the mid and lower dermis.

A Case of Scleredema / 대한피부과학회지

Scleredema is a rare scleradematosis of unknown cause involving the face, neck, upper portion of the trunk, and proximal upper extremities. The clinical features of the disease are nonpitting indurated edema or stiffness of the neck, which may be sudden or insidious in onset. Diabetes mellitus and its complications have been frequently described to be associated with this disease. We present a case of scleredema developed on the nape, upper portion of the back and shoulder in 60-year-old man who had been suffered from diabetes mellitus for the past ten years.