Skin nontumor
Dermal collagen and elastic tissue alterations and metabolic disorders
Scleredema
Last author update: 1 August 2011
Last staff update: 5 August 2020
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PubMed Search: Scleredema of Buschke
Table of Contents
Definition / general | Clinical features | Case reports | Microscopic (histologic) description | Negative stains | Differential diagnosis | Additional referencesCite this page: Hamodat M. Scleredema. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorscleredema.html. Accessed April 1st, 2025.
Definition / general
- Nonpitting, woody induration of upper back skin; associated with diabetes
- Rare primary mucinosis that presents with nonpitting indurated edema and associated dermal hardening in the absence of any clinical abnormality
- After viral infection, especially UTI or insidious onset with no prior acute illness
- Occasionally associated with paraproteinemia, secondary hyperparathyroidism, rheumatoid arthritis, Sjogren syndrome, HIV infection and nuchal fibroma
Clinical features
- Symmetrical nonpitting edema and dermal hardening, which affects the posterior and lateral aspect of the neck, face, upper trunk and upper limbs
- Rarely affects lower abdomen and legs
Case reports
- 72 year old man with diabetes associated disease (Dermatol Online J 2003;9:11)
Microscopic (histologic) description
- Epidermis appear slightly thinned or normal
- Thickened reticular dermis, often at expense of subcutaneous fat; eccrine glands in upper third of mid dermis
- Collagen fibers are broadened, abnormally separated by clear spaces, which may contain mucin
- May be mild chronic inflammatory cell infiltrate in superficial dermis, increased mast cells but normal amount of fibroblasts
Negative stains
- Negative direct immunofluorescence
Differential diagnosis
- Scleroderma: appendages are atrophic or absent; diffuse dermal sclerosis, not the fenestrated appearance of scleredema
Additional references
