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</div><div><span>Scleredema diabeticorum</span></div></div>
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</a><h1 class="with-also" itemprop="name">Scleredema diabeticorum</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>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.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p> 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:</p><ul><li>Are obese</li><li>Use insulin</li><li>Have poor blood sugar control</li><li>Have other diabetes complications</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p> Skin changes happen slowly. Over time, you may notice:</p><ul><li>Thick, hard skin that feels smooth. You cannot pinch the skin over the upper back or neck.</li><li>Reddish, painless lesions.</li><li>Lesions occur on the same areas on both sides of the body (symmetrical).</li></ul><p>In severe cases, thickened skin can make it hard to move the upper body. It also can make deep breathing difficult.</p><p>Some people find it hard to make a clenched fist because the skin on the back of the hand is too tight.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p> Your health care provider will perform a physical exam. You will be asked about your medical history and symptoms.</p><p>Tests may include:</p><ul><li>Fasting blood sugar</li><li><a test="test" href="./003466.htm">Glucose tolerance test</a></li><li><a test="test" href="./003640.htm">Hemoglobin A1C test</a></li><li><a test="test" href="./003840.htm">Skin biopsy</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p> There is no specific treatment for scleredema. Treatments may include:</p><ul><li>Improved control of blood sugar (this may not improve the lesions once they have developed)</li><li>Phototherapy, a procedure in which the skin is carefully exposed to ultraviolet light</li><li>Glucocorticoid medications (topical or oral)</li><li>Electron beam therapy (a type of radiation therapy)</li><li>Medicines that suppress the immune system</li><li>Physical therapy, if you find it hard to move your torso or breathe deeply</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>The condition cannot be cured. Treatment may improve movement and breathing.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p> Contact your provider if you:</p><ul><li>Have trouble controlling your blood sugar</li><li>Notice symptoms of scleredema</li></ul><p>If you have scleredema, contact your provider if you:</p><ul><li>Find it hard to move your arms, shoulders, and torso, or hands</li><li>Have trouble breathing deeply due to tight skin</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p> Keeping blood sugar levels within a healthy range helps prevent diabetes complications. However, scleredema can occur, even when blood sugar is well controlled.</p><p>Your provider may discuss adding medicines that allow insulin to work better in your body so that your insulin doses can be reduced.<br/><br/></p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Scleredema of Buschke; Scleredema adultorum; Diabetic thick skin; Scleredema; Diabetes - scleredema; Diabetic - scleredema; Diabetic dermopathy</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Flischel AE, Helms SE, Brodell RT. Scleredema. In: Lebwohl MG, Heymann WR, Coulson IH, Murrell DF, eds. <em>Treatment of Skin Disease: Comprehensive Therapeutic Strategies</em>. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 223.</p><p>James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Mucinoses. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. <em>Andrews' Diseases of the Skin: Clinical Dermatology</em>. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 9.</p><p>Patterson JW. Cutaneous mucinoses. In: Patterson JW, ed. <em>Weedon's Skin Pathology</em>. 5th ed. Philadelphia, PA: Elsevier Limited; 2021:chap 14.</p><p>Rongioletti F. Mucinoses. In: Bolognia JL, Schaffer JV, Cerroni L, eds. <em>Dermatology</em>. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 46.</p><p>Simms RW. Localized scleroderma and scleroderma-like syndromes. In: Hochberg MC, Gravallese EM, Smolen JS, van der Heijde D, Weinblatt ME, Weisman MH, eds. <em>Rheumatology</em>. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 155.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 6/7/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Elika Hoss, MD, Assistant Professor of Dermatology, Mayo Clinic, Scottsdale, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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