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July 21, 2008

Scleredema Diabeticorum Case Series: Successful Treatment With UV-A1

Arch Dermatol. 2008;144(7):947-948. doi:10.1001/archderm.144.7.947

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. We report herein the effect of UV-A1 treatment (340-400 nm) in 3 patients with severe scleredema diabeticorum.

Two men (patients 1 and 2) and 1 woman (patient 3) (aged 51, 66, and 52 years, respectively) with long-standing, difficult-to-regulate diabetes mellitus presented with a history of tightening of the skin on their backs. Examination revealed nonpitting induration of the back, neck, and shoulders. The mobility of the neck and shoulders was severely limited. No other skin abnormalities or laboratory disorders (eg, paraproteinemia or eosinophilia) were seen. The histologic findings included a thickened broad dermis with mucin between thickened collagen bundles, consistent with scleredema diabeticorum (Figure 1).