This presentation — known as scleredema diabeticorum — is characterised by symmetrical, woody, non-pitting skin induration of the neck and upper trunk, with the fingers typically spared. It occurs predominantly in men with diabetes mellitus.
Treatment is guided by an individual risk–benefit assessment. The approach draws from a range of systemic and interventional therapies, with selection depending on the patient's clinical profile and response to prior treatment.
DOI: 10.1111/jdv.19937
Type 3 scleroedema was named 'scleredema diabeticorum' by Krakowski and colleagues, and manifests mostly in men with diabetes mellitus.
If methotrexate fails or is contraindicated, based on a risk–benefit approach, the following alternative treatments can be proposed: glucocorticoids, systemic or intralesional, cyclosporine, prostaglandin E1, intravenous immunoglobulins, high-dose penicillin, factor XIII infusion, cyclophosphamide, tranilast, thalidomide, bortezomib, radiotherapy, extracorporeal shock wave therapy, electron-beam radiotherapy and extracorporeal photopheresis.
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