A 70-year-old Japanese man with non-insulin-dependent diabetes mellitus showed scleredema diabeticorum. The patient complained of edematous feelings on his hands, both arms and face. The time of onset of these symptoms was not known. He had typical clinical and histopathological findings of diabetic scleredema. His diabetic control was poor and HbA1c level was 8.2% under insulin treatment. The patient had many complications such as diabetic retinopathy, diabetic nephropathy with benign nephrosclerosis, hyperlipidemia accompanied with a low level of high density lipoprotein cholesterol, hypertension and coronary heart disease. There were no abnormal laboratory findings except the diabetic controls and mild abnormal renal functions; however erythrocyte sedimentation rate was high.
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Article Synopsis
- Scleredema adultorum of Buschke is a condition characterized by thickening of the skin, particularly starting at the neck and spreading, which can limit mobility due to increased dermal stiffness.
- Diagnosis relies on histological evidence of mucin deposits and is differentiated from other sclerosing diseases, with three subtypes linked to infections, paraproteins, or diabetes.
- Treatment includes physiotherapy and therapies like ultraviolet irradiation, along with addressing underlying conditions, particularly focusing on optimizing diabetes management to reduce insulin use.
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