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58-year-old with red tight skin on upper back
Last reviewed: December 2022
Author: Dr Ian Coulson, Consultant Dermatologist and Editor-in-Chief, 2022.
Edited by the DermNet content department
Background
This 58-year-old man has developed thick purple/red tight skin on his upper back, over the last three months. He is otherwise well and does not take any medication. In particular, he has not had symptoms of Raynaud phenomenon.
What is this condition?
This is scleroedema (U.S. scleredema), not to be confused with scleroderma. It occurs as a result of the accumulation of mucin in the dermis.
What is it associated with?
It may be associated with a paraprotein, diabetes, and can occur acutely after a respiratory infection. Less robust associations include Sjogren syndrome, rheumatoid arthritis, hyperparathyroidism, and HIV infection.
How can the diagnosis be confirmed?
Testing for associated biochemical abnormalities (paraprotein, immunoglobulins, HbA1c) should be conducted. Skin biopsy will show accumulation of dermal mucin.