Chapter 67 - Scleredema and Scleromyxedema

Question 1

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

EPIDEMIOLOGY
Childhood or adolescence
Adulthood

Answer 1

Scleredema

Question 2

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

EPIDEMIOLOGY
Mid to late adulthood, males and females equally affected 

Answer 2

Scleromyxedema
(also, lichen myxedematosus)

Question 3

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

ASSOCIATED CONDITIONS
Postinfectious

Answer 3

Scleredema
(Childhood or adolescence)

Question 4

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

ASSOCIATED CONDITIONS
Diabetes mellitus
Paraproteinemia
Hyperparathyroidism, connective tissue disease, HIV

Answer 4

Scleredema
(Adulthood)

Question 5

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

ASSOCIATED CONDITIONS
Paraproteinemia

Answer 5

Scleromyxedema
(also, lichen myxedematosus)

Question 6

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

CLINICAL MANIFESTATIONS
Acute onset, nonpitting neck induration; shoulders, upper back, face, and arms may be affected. Affected skin feels smooth and waxy.

Answer 6

Scleredema

Question 7

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

CLINICAL MANIFESTATIONS
Generalized lichenoid eruption has minute papules on extremities and trunk
Confluent, lichenoid plaques

Answer 7

Scleromyxedema
(also, lichen myxedematosus)

Question 8

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

HISTOLOGIC FINDINGS
“Squared” appearance on low-power microscopy; more dermis in affected skin compared to adjacent unaffected skin; decreased number/higher placement of eccrine glands; mucin stains (Alcian blue, colloidal iron) can identify mucin deposits   

Answer 8

Scleredema

Question 9

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

HISTOLOGIC FINDINGS
Superficial to mid-dermal fibroplasia and mucin deposition

Answer 9

Scleromyxedema
(also, lichen myxedematosus)

Question 10

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

COURSE/ PROGNOSIS
Abates in 1-2 years

Answer 10

Scleredema
(Childhood or adolescence)

Question 11

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

COURSE/ PROGNOSIS
Protracted course

Answer 11

Scleredema
(Adulthood)
(Diabetes mellitus, Paraproteinemia)

Question 12

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

COURSE/ PROGNOSIS
Chronic, resistant to therapies

Answer 12

Scleredema
(Adulthood)
(Hyperparathyroidism, Connective tissue disease, HIV)

Question 13

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

COURSE/ PROGNOSIS
Chronic, progressive course

Answer 13

Scleromyxedema
(also, lichen myxedematosus)

Question 14

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

TREATMENT OPTIONS
Treatment of underlying condition;
UVA-1 phototherapy may be effective   

Answer 14

Scleredema

*Treatment of underlying condition (except for postinfectious scleredema)

Question 15

TABLE 67-1
Scleredema and Scleromyxedema

DIAGNOSIS

TREATMENT OPTIONS
Treatment of underlying cause

Answer 15

Scleromyxedema
(also, lichen myxedematosus)