Scleredema Diabeticorum in a Patient with the Normal Range of the Hemoglobin A1c Level and Impaired Glucose Tolerance


Scleredema diabeticorum is an uncommon skin disorder showing a diffuse, symmetrical, and non-pitting persistent in-duration developing initially on the nape. It usually occurs in patients with poorly controlled or insulin-resistant diabetes mellitus. We present a 57-year-old woman with scleredema diabeticorum with hemoglobin A1c 6.1% (normal, 4.7% - 6.2%) and impaired glucose tolerance. Alcian blue staining at pH 7.0 illustrated deposits of acid mucopolysaccharides between the collagen bundles in the reticular dermis, but the staining at pH 1.5 did not show the deposits. This case indicates that scleredema diabeticorum may be an early indicator of undiagnosed diabetes mellitus in some cases, and that impaired glucose tolerance test should be performed for individuals with scleredema even though the hemoglobin A1c level is within the normal range.

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H. Matsuda, N. Oiso, Y. Fujita, H. Ikegami and A. Kawada, "Scleredema Diabeticorum in a Patient with the Normal Range of the Hemoglobin A1c Level and Impaired Glucose Tolerance," Journal of Cosmetics, Dermatological Sciences and Applications, Vol. 2 No. 3, 2012, pp. 141-143. doi: 10.4236/jcdsa.2012.23028.

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The authors declare no conflicts of interest.


[1] N. Thumpimukvatana, C. Wongpraparut and H. W. Lim, “Scleredema Diabeticorum Successfully Treated with Ultraviolet A1 Phototherapy,” Journal of Dermatology, Vol. 37, No. 12, 2010, pp. 1036-1039. doi:10.1111/j.1346-8138.2010.01014.x
[2] F. Breuckmann, C. Appelhans, A. Harati, S. Rotterdam, P. Altmeyer and A. Kreuter, “Failure of Low-Dose Methotrexate in the Treatment of Scleredema Diabeticorum in Seven Cases,” Dermatology, Vol. 211, No. 3, 2005, pp. 299-301. doi:10.1159/000087031
[3] R. S. Gilgor and G. S. Lazarus, “Skin Manifestations of Diabetes Mellitus,” In: H. Rifkin and P. Raskin, Eds., Diabetes Mellitus, Brady Company, Bowie, 1981, pp. 313-321.
[4] P. K. Nigam, L. Sharma, J. K. Agrawal, G. Singh and S. K. Khurana, “Glucose Tolerance Studies in Lichen Planus,” Dermatologica, Vol. 175, No. 6, 1987, pp. 284-289. doi:10.1159/000248835
[5] M. M. Seyger, F. H. van den Hoogen, S. de Mare, U. van Haelst and E. M. de Jong, “A Patient with a Severe Scleroedema Diabeticorum, Partially Responding to Low-Dose Methotrexate,” Dermatology, Vol. 198, No. 2, 1999, pp. 177-179. doi:10.1159/000018103
[6] C. Meguerditchian, P. Jacquet, S. Béliard, T. Benderitter, R. Valéro, F. Carsuzza and B. Vialettes, “Scleredema Adultorum of Buschke: An under Recognized Skin Complication of Diabetes,” Diabetes & Metabolism, Vol. 32, No. 5, 2006, pp. 481-484.
[7] A. Krakowski, J. Covo and C. Berlin, “Diabetic Scleredema ,” Dermatologica, Vol. 146, No. 3, 1973, pp. 193-198. doi:10.1159/000251956

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