Scleredema diabeticorum

定义

Scleredema diabeticorum is a skin condition that occurs in some people with diabetes. It causes skin to become thick and hard on the back of the neck, shoulders, arms, and upper back.

选择的名字

Scleredema of Buschke; Scleredema adultorum; Diabetic thick skin; Scleredema; Diabetes - scleredema; Diabetic - scleredema; Diabetic dermopathy

原因

Scleredema diabeticorum is thought to be a rare disorder, but some people think that the diagnosis is often missed. The exact cause is unknown. The condition tends to occur in men with poorly-controlled diabetes who:

• 肥胖
• 使用胰岛素
• Have poor blood sugar control
• Have other diabetes complications

症状

Skin changes happen slowly. Over time, you may notice:

• Thick, hard skin that feels smooth. You cannot pinch the skin over the upper back or neck.
• Reddish, painless lesions.
• Lesions occur on the same areas on both sides of the body (symmetrical).

In severe cases, thickened skin can make it hard to move the upper body. It also can make deep breathing difficult.

Some people find it hard to make a clenched fist because the skin on the back of the hand is too tight.

考试和测试

Your health care provider will perform a physical exam. You will be asked about your medical history and symptoms.

测试可能包括:

• 空腹血糖
• 葡萄糖耐量试验
• 糖化血红蛋白测试
• 皮肤活组织检查

治疗

There is no specific treatment for scleredema. 治疗 may include:

• Improved control of blood sugar (this may not improve the lesions once they have developed)
• Phototherapy, a procedure in which the skin is carefully exposed to ultraviolet light
• Glucocorticoid medications (topical or oral)
• Electron beam therapy (a type of radiation therapy)
• Medicines that suppress the immune system
• Physical therapy, if you find it hard to move your torso or breathe deeply

前景(预测)

The condition cannot be cured. 治疗 may improve movement and breathing.

When to Contact a Medical Professional

Contact your provider if you:

• Have trouble controlling your blood sugar
• Notice symptoms of scleredema

If you have scleredema, contact your provider if you:

• Find it hard to move your arms, shoulders, and torso, or hands
• Have trouble breathing deeply due to tight skin

预防

Keeping blood sugar levels within a healthy range helps prevent diabetes complications. However, scleredema can occur, even when blood sugar is well controlled.

Your provider may discuss adding medicines that allow insulin to work better in your body so that your insulin doses can be reduced.

参考文献

Flischel AE, Helms SE, Brodell RT. Scleredema. In: Lebwohl MG, Heymann WR, Coulson IH, Murrell DF, eds. 治疗 of Skin Disease: Comprehensive Therapeutic Strategies. 6日艾德. Philadelphia, PA: Elsevier; 2022:chap 223.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Mucinoses. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical 皮肤病学. 13日艾德. Philadelphia, PA: Elsevier; 2020:chap 9.

帕特森JW. 皮肤mucinoses. 见:帕特森JW编. 威登氏皮肤病理学. 5日艾德. Philadelphia, PA: Elsevier Limited; 2021:chap 14.

Rongioletti F. Mucinoses. In: Bolognia JL, Schaffer JV, Cerroni L, eds. 皮肤病学. 第四版. Philadelphia, PA: Elsevier; 2018:chap 46.

希姆斯RW. Localized scleroderma and scleroderma-like syndromes. In: Hochberg MC, Gravallese EM, Smolen JS, van der Heijde D, Weinblatt ME, Weisman MH, eds. 风湿病学. 8日艾德. Philadelphia, PA: Elsevier; 2023:chap 155.