CLINICAL CASE – SCLEREDEMA ADULTORUM

Abstract

Scleredema of Buschke is a rare dermal disease of unknown etiology which is characterized by a dense diffuse swelling of the derm and subcutaneous adipose tissue. It characterized by induration of the skin which includes a non-pitting hardening of the skin around the neck, shoulders, and trunk sometimes the face. Three basic forms are distinguished: classical, idiopathic, diabetic or metabolic.

The histopathological features of scleredema are characterized by sharply thickened derma, edema and structural impairment of collagenous fascicles metachromasia appears in the foci of the damage as a result of accumulation of glycosaminoglycans. Differential diagnostics was carried out at the other diseases similar to scleredema such as systemic scleroderma, eosinophilic fasciitis, porphyria cutanea tarda hereditaria, porphyria cutanea scleroderma-like form, Werner's syndrome, scleromyxedema, amyloidosis. Several treatments are suggested in the literature.

The present case record describes scleredema adultorum Buschke in a 52- years-old male with stiffness and density of the skin of trunk. He had suffered from diabetes mellitus type-1 for more than 30 years. The patient was treated with antibiotics, corticosteroids, polyenzyme agent, hepatoprotector, cytoflavin, polyvitamins. There was improvement with slightly decrease infiltration in foci lesions, skin color in the area of rash brightened.

Skin diseases are common in diabetes mellitus. This clinical case will enable to expand knowledge of general practitioners about the rare dermal disease – Buschke's scleredema giving the possibility to reveal such patients at early stages of the disease in proper time.