Scleredema Adultorum. Presented by Dr. Anthony N. Domonkos.
This 63-year-old man noted a stiffening of the skin on the posterior neck and upper back ten months ago. This has gotten progressively "tougher" and harder with concomitant inability to raise his arms to a horizontal position. He has not had a similar type of change in his skin elsewhere.In 1959 he had episodes of abdominal pain and discomfort. Gastrointestinal x-ray studies and cholecystogram were negative and within normal limits. In 1961 he had a 4+ Kolmer, 4+ Mazzini, and a positive TPI. He was adequately treated with penicillin. He also has had diabetes for the past 20 years.
Over the upper regions of the back and nape of neck is an extremely indurated and brawny skin. There is no pitting on pressure. The other parts of his skin are normal.
Laboratory studies disclosed the following values:
NEW YORK DERMATOLOGICAL SOCIETY. Arch Dermatol. 1965;92(1):107–110. doi:10.1001/archderm.1965.01600130113024
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