Skin nontumor

Dermal collagen and elastic tissue alterations, and cutaneous deposits


Last author update: 1 August 2011
Last staff update: 5 August 2020

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PubMed Search: Scleredema of Buschke

Mowafak Hamodat, M.B.Ch.B., M.Sc.
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Cite this page: Hamodat M. Scleredema. website. Accessed September 25th, 2023.
Definition / general
  • Nonpitting, woody induration of upper back skin; associated with diabetes
  • Rare primary mucinosis that presents with nonpitting indurated edema and associated dermal hardening in the absence of any clinical abnormality
  • After viral infection, especially UTI or insidious onset with no prior acute illness
  • Occasionally associated with paraproteinemia, secondary hyperparathyroidism, rheumatoid arthritis, Sjogren syndrome, HIV infection and nuchal fibroma
Clinical features
  • Symmetrical nonpitting edema and dermal hardening, which affects the posterior and lateral aspect of the neck, face, upper trunk and upper limbs
  • Rarely affects lower abdomen and legs
Case reports
Microscopic (histologic) description
  • Epidermis appear slightly thinned or normal
  • Thickened reticular dermis, often at expense of subcutaneous fat; eccrine glands in upper third of mid dermis
  • Collagen fibers are broadened, abnormally separated by clear spaces, which may contain mucin
  • May be mild chronic inflammatory cell infiltrate in superficial dermis, increased mast cells but normal amount of fibroblasts
Negative stains
  • Negative direct immunofluorescence
Differential diagnosis
  • Scleroderma: appendages are atrophic or absent; diffuse dermal sclerosis, not the fenestrated appearance of scleredema
Additional references
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