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April 2010

Ultrasonic Massage and Physical Therapy for Scleredema: Improving Activities of Daily Living

Author Affiliations

Author Affiliations: Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania.

Arch Dermatol. 2010;146(4):453-454. doi:10.1001/archdermatol.2010.31

Scleredema results in the loss of function in the upper torso and extremities owing to increased collagen and mucin production in the skin. Since the disease is relatively rare, evidence-based treatments are lacking, leaving patients with limited options for disease resolution. Owing to our patient's lack of improvement with standard therapies, ultrasonic massage and physical therapy were instituted to help him in his activities of daily living.

A 42-year-old man with diabetes presented to our clinic complaining of a 10-year history of tight skin on his upper back and marked limited range of motion of his shoulders and neck. A wedge biopsy specimen showed dermal deposition of glycosaminoglycans, demonstrated by colloidal iron and alcian blue stains, and increased collagen bundles, confirming our clinical impression of scleredema. Serum protein electrophoresis failed to reveal a monoclonal gammopathy.

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