Presentation
We present a case of scleredema associated with hypergammaglobulinemia. The skin findings had been progressive for 2 years before he was diagnosed with scleredema. [ncbi.nlm.nih.gov]
TY - JOUR T1 - Scleredema adultorum of Buschke presenting as periorbital edema: a diagnostic challenge. [wwww.unboundmedicine.com]
If infection is present, antibiotics may be required. If diabetes is present, it should be controlled with diet, exercise, and medication. Physical therapy may help if movement of body parts is restricted. VeryWell. [sclero.org]
Entire Body System
- Fatigue
However, the patient treated with mixed photon therapy developed sore throat, nausea, fatigue, and headache during treatment. [appliedradiationoncology.com]
CASE REPORTS Case 1 A 55-year-old white man (skin type IV) had a 10year history of general fatigue and progressive tightness and thickening of the skin of his upper and lower extremities and back. [kundoc.com]
The treatment was well tolerated with the exception of patient 2, who received a combination of penetrating photons and electron-beam therapy and who complained of a temporary sore throat, headache, and fatigue. [jamanetwork.com]
While the aggressive disease can be associated with constitutional symptoms such as profound fatigue and loss of weight, there is usually no visceral involvement. [indianjrheumatol.com]
Gastrointestinal
- Progressive Dysphagia
A 55-yr-old white female with biopsy proven scleredema adultorum was evaluated for progressive dysphagia. [ncbi.nlm.nih.gov]
She then developed hoarseness of voice and progressive dysphagia. There was no history of cough, dyspnea, nasal regurgitation or gastroesophageal reflux. [ijdvl.com]
Am J Gastroenterol 1982 Jan;77(1):9-11 Abstract quote A 55-yr-old white female with biopsy proven scleredema adultorum was evaluated for progressive dysphagia. [thedoctorsdoctor.com]
- Regurgitation
One patient complained of increasing dysphagia with regurgitation and aspiration. Manometry and X-ray cinematographic investigation showed inappropriate relaxation of the upper oesophageal sphincter. [ncbi.nlm.nih.gov]
There was no history of cough, dyspnea, nasal regurgitation or gastroesophageal reflux. Clinical examination showed thickened skin with induration in the face, neck, chest, back, arms and forearms. Skin was normal in fingers and toes. [ijdvl.com]
- Odynophagia
No dysphasia or odynophagia nor constipation. No chest pain, palpitation or dyspnea. [shmabstracts.com]
Cardiovascular
- Chest Pain
He denied any history of pharyngitis, skin tightness on fingers, feet or face, no joint pain. No dysphasia or odynophagia nor constipation. No chest pain, palpitation or dyspnea. [shmabstracts.com]
Skin
- Insect Bite
She had no history of an insect bite. Cutaneous examination revealed a well-defined erythematous, shiny, firm, non-tender plaque (measuring 3 cm X 4 cm) on the extensor surface of the lower third of her left forearm. [cyberleninka.org]
Musculoskeletal
- Frozen Shoulder
He noticed the progressive limitation of the left shoulder motility and was referred to a rheumatologist. This specialist diagnosed a diabetes-related frozen shoulder and prescribed local corticosteroid injection followed by physiotherapy. [em-consulte.com]
- Proximal Muscle Weakness
No clinical evidence of proximal muscle weakness. With this clinical presentation, a provisional diagnosis of scleredema was made. [ijdvl.com]
- Arthralgia
Up to 9% of these patients can have arthralgias. [6] Unlike SSc, however, digital ulceration, nail fold capillary changes, Raynaud's phenomenon, resorption of phalanges, and internal organ involvement is very rare. [indianjrheumatol.com]
Neurologic
- Neglect
It is worthy to note that most of the cases in this series were previously unrecognised or neglected by MP or diabetologists. [em-consulte.com]
- Dysphasia
No dysphasia or odynophagia nor constipation. No chest pain, palpitation or dyspnea. [shmabstracts.com]
Workup
Additional workup may be necessary that includes imaging studies and recruitment of subspecialists to treat affected organs. For example, scleredema involving the heart muscles may lead to cardiomyopathy resulting in congestive heart failure. [clinicalpainadvisor.com]
Treatment
[…] as the first-line treatment of this disease. [ncbi.nlm.nih.gov]
Patient 1 received electron-beam treatment to a new area, the abdomen, 6 months after initial neck and shoulder treatment; patient 2 received additional photon treatment to his left forearm 16 months after initial treatment; and patient 3 received a repeat [jamanetwork.com]
(Also see Lichen Sclerosus ) Treatments For UVA1 treatment, first contact your doctor to see if it they will recommend it for you. It is not used for lichen sclerosus that is on the genital area. [sclero.org]
Treatment Options Treatment options for scleredema are summarized in Table I. Table I. [clinicalpainadvisor.com]
Prognosis
The practical importance of knowing scleredema adultorum rests on the fact that the disease is benign and self-limited but is easily mistaken for conditions which carry a poor prognosis and tend to be progressive. [jamanetwork.com]
Conclusions: Awareness of this disease is very important as its treatment, prognosis differs significantly with scleroderma, a more common but similar medical condition. To cite this abstract: 2Ugbarugba E, Aninyei M. [shmabstracts.com]
The possibility of systemic involvement makes early diagnosis critical for proper treatment and better prognosis. REFERENCES 1 Gervini RL, Lecompte SM, Pineda RCB, Ruthner FG, Magnabosco EM, Silva LMC. Escleredema de Buschke: relato de dois casos. [scielo.br]
Prognosis in systemic sclerosis is poor and often fatal, with 10 year survival ranging from 54–66% [10]. [ijcasereportsandimages.com]
Etiology
Its etiology is unknown, but there may be a preceding history of infection and there is a known association with diabetes mellitus. Women are more frequently affected. Usually, the disease is self-limiting but some patients show progressive disease. [ncbi.nlm.nih.gov]
Engelsk definition A diffuse, non-pitting induration of the skin of unknown etiology that occurs most commonly in association with diabetes mellitus, predominantly in females. [mesh.kib.ki.se]
Scleredema adultorum of Buschke characterized by thickening and hardening of the skin is an uncommon sclerotic disorder of unknown etiology. Scleredema adultorum of Buschke is an uncommon disorder of unknown origin. [freethesaurus.com]
Epidemiology
Epidemiology of genital chlamydial infections in patients with chlamydial conjunctivitis: a retrospective study. Genitourinary medicine 1996; 72:203-205. Hammerschlag MR. Chlamydia trachomatis. In: Nelson textbook of paediatrics. 16th ed. [md-medicaldata.com]
[…] due to mechanical stress. [16] Drug reaction: In 2005, scleredema was reported in association with the use of infliximab; although rare, treating physicians should consider the possibility of an adverse drug reaction as the underlying etiology. [17] Epidemiology [emedicine.medscape.com]
Based on the epidemiological data, Ballantyne, a British physician, argued erroneously that SN and ‘oedema neonatorum’ were the same disease. [nature.com]
[…] skin and subcutaneous tissues leading to sclerosis. [4] The absence of features such as Raynaud's phenomenon, sclerodactyly, nail bed capillary abnormalities and involvement of the internal organs differentiates localized from systemic scleroderma. [4] Epidemiology [indianjrheumatol.com]
Pathophysiology
Scleredema, an uncommon condition with unknown pathophysiologic characteristics, is characterized by nonpitting induration of the skin with occasional erythema. Limited options are available to treat patients with scleredema diabeticorum. [jamanetwork.com]
Etiology Pathophysiology The pathogenesis of scleredema is poorly understood. [clinicalpainadvisor.com]
Pathophysiology Increased deposition of collagen and mucin (hyaluronic acid, an acid mucopolysaccharide) is seen in this condition; however, the causative mechanism is unknown. [emedicine.medscape.com]
Prevention
Though the benign nature of the disease is the rule in most cases, the systemic involvement has to be looked for and appropriately treated to prevent morbidity and mortality in scleredema adultorum of Buschke. [ijdvl.com]
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]
Patients with scleredema have to be screened for internal organ involvement to prevent mortality. Kavitha Mohanasundaram, Subramaniyan Kumarasamy, Ramesh Kumar, Chandran P. [cyberleninka.org]
Physical therapy is recommended to prevent limitations in range of motion. However, no trials have been performed to evaluate the benefit of physical therapy. References 1. Venencie PY, et al. Scleredema: review of 33 cases. [dermatology.cdlib.org]
[…] blood sugar Notice symptoms of scleredema If you have the scleredema, call your provider if you: Find it hard to move your arms, shoulders, and torso, or hands Have trouble breathing deeply due to tight skin Keeping blood sugar levels within range helps prevent [medlineplus.gov]