Scleredema Treatment & Management

  • Author: Misha A Rosenbach, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jun 17, 2010
 

Medical Care

Appropriate antibiotic therapy should be started in scleredema patients if infection is detected, although antibiotics do not appear to shorten the course of skin findings in scleredema.

Evaluation and treatment for blood dyscrasias and diabetes mellitus should be completed in scleredema patients.

Case reports in scleredema patients also describe scleredema occurring in association with internal malignancies (eg, carcinoma of the gall bladder,[17] malignant insulinoma,[18] carcinoid tumor[19] ). Imaging studies are warranted if this is suggested based on clinical findings.

Rare reports describe scleredema following scabies infestation; appropriate evaluation for possible antecedent infestation may be warranted.[20]

In 2005, scleredema was reported in association with the use of infliximab; although rare, treating physicians should consider the possibility of an adverse drug reaction as the underlying etiology.[21]

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Consultations

Consultation with an internal medicine or pediatrics specialist may be necessary. Refer individuals for further evaluation and management in cases of detected blood dyscrasias and/or monoclonal gammopathies. Refer patients with diabetes mellitus–associated scleredema, although most of these patients have diabetes that has been present for years before the onset of scleredema.

Consultation with a physical therapist may be necessary. Refer patients with range of motion difficulties. Prompt attention to physical therapy can potentially reduce long-term range of motion limitations.

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Diet

No restrictions are necessary.

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Activity

No restrictions are necessary.

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Contributor Information and Disclosures
Author

Misha A Rosenbach, MD  Assistant Professor, Departments of Medicine and Dermatology, Hospital of the University of Pennsylvania

Misha A Rosenbach, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Academy, Medical Dermatology Society, and Women's Dermatologic Society

Disclosure: Centocor Grant/research funds None

Coauthor(s)

Victoria P Werth, MD  Professor of Dermatology and Medicine, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, Philadelphia Veterans Affairs Medical Center

Victoria P Werth, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American College of Rheumatology, Medical Dermatology Society, Phi Beta Kappa, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Susan M Swetter, MD  Director, Pigmented Lesion and Cutaneous Melanoma Clinic, Professor, Department of Dermatology, Stanford University Medical Center, Veterans Affairs Palo Alto Health Care System

Susan M Swetter, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Clinical Oncology, Eastern Cooperative Oncology Group, Pacific Dermatologic Association, Society for Investigative Dermatology, Society for Melanoma Research, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD  Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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Middle-aged man who has diabetes with scleredema on the upper part of the back.
Middle-aged man who has diabetes with scleredema on the upper part of the back.
 
 
 
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