Treatment of Scleredema Following Febrile Streptococcal or Viral Respiratory Tract Infection

This protocol applies to scleredema presenting in the classic post-infectious pattern: onset linked to a preceding febrile streptococcal or viral respiratory tract illness, with characteristic woody, non-pitting skin induration beginning on the neck and extending to the upper trunk, shoulders, and arms.

Clinical Scenario

The patient has a history of a preceding febrile streptococcal or viral respiratory tract infection. Examination reveals symmetrical, woody, non-pitting skin induration starting on the neck and spreading to the upper trunk, shoulders, and arms, with sparing of the fingers.

Treatment Approach (partial overview)

For persistent disease in this setting, the structured regimen centres on a phototherapy-based intervention — the complete protocol, including specific modalities and the full management pathway, is available below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/jdv.19937

Type 1 scleroedema (the classic 'Buschke' type, 55% of cases) usually follows a febrile infection, especially streptococcal or viral respiratory tract infection, and affects mainly children and women.
Type 1 scleroedema starts suddenly 1–3 weeks after respiratory infection with fever and usually resolves in a few months.
Escalation of therapy in resistant cases of scleroedema is possible through the use of phototherapy (PUVA, UVA1 and narrowband UVB) or drug treatment (Table 2).
The recommended first-line treatment is phototherapy.

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