成人硬肿病并发糖尿病一例

患者,男,52岁。主因颈背部皮肤红肿变硬10余年、伴瘙痒3年,于2011年2月9日就诊。患者10余年前无诱因出现颈项及背部皮肤增厚、变硬、红肿,逐渐加重。3年来背部出现轻度瘙痒,     

Scleredema adultorum of buschke associated with non-scarring alopecia of scalp

A 3 year old boy presenting with scleredema of Buschke confirmed histopathologically is being reported for its unusual association with reversible non-cicatricial alopecia of the scalp.     

Scleredema adultorum associated with a monoclonal gammopathy and generalized hyperpigmentation

Scleredema associated with a monoclonal gammopathy and generalized skin pigmentation is described in a 56-year-old man with hyperlipoproteinemia and cardiovascular disease. The patient had IgG-lambda paraproteinemia, without any evidence of multiple myeloma or immunoglobulin deposition in affected skin. Ultrastructural studies of pigmented lesional skin showed increased transfer of melanosomes to basal keratinocytes and dermal melanophages containing complex melanosomes. In addition, cytoplasmic, electron-opaque lipid droplets were seen in approximately every third keratinocyte or melanocyte, while only an occasional dermal cell contained lipid droplets. The hyperpigmentation appeared to be directly related to the scleredema, while the lipid deposition in skin was a likely consequence of the hyperlipoproteinemia. The findings further support the contention that paraproteinemia and hyperpigmentation may, in some patients, be associated features of scleredema adultorum.     

Scleredema adultorum of Buschke treated with radiation

BACKGROUND: Scleredema adultorum of Buschke is an uncommon skin condition that may accompany diabetes mellitus. Current therapeutic options are poor, with only case reports and small series supporting their use. OBSERVATION: We describe 3 patients with severe restrictive scleredema associated with type 2 diabetes mellitus who responded to radiation therapy after other treatments had failed. Angle of shoulder abduction was used as an objective measurement of improvement, while the patients rated several subjective areas, including arm range of motion, ease of performing daily tasks, ease of breathing, and neck thickening. Objective improvement tended to plateau over time but remained well above baseline. The duration of subjective improvement was variable, lasting from a few months to the end of the observation time of 2 1/2 years. CONCLUSION: Though not consistently durable in its effect, radiation therapy appears to be a viable therapeutic option in extreme cases of this difficult-to-treat disease.     

Scleredema adultorum associated with IgG-kappa multiple myeloma–a case report and review of the literature

The coexistence of monoclonal gammopathy with scleredema is an already known but unusual finding. However, the association of scleredema with multiple myeloma has only rarely been reported. A case of widespread longstanding scleredema is presented in which the finding of monoclonal gammopathy subsequently progressed to oven IgG-kappa multiple myeloma. From a review of the literature, it was concluded that scleredema patients having monoclonal gammopathy with or without multiple myeloma, share a number of clinical and laboratory features: (1) a widespread long-standing eruption; (2) no preceding upper respiratory tract infection and usually without accompanying diabetes mellitus; (3) most commonly identified paraprotein is IgG having a kappa light chain. It is suggested that scleredema should be included in the list of diseases related to monoclonal gammopathy, the latter either denoting monoclonal gammopathy of undetermined significance or representing an already existing or incipient multiple myeloma.     

Scleredema adultorum and diabetes mellitus (scleredema diutinum)

A case of scleredema adultorum associated with long standing poorly controlled diabetes mellitus is reported and the relevant literature reviewed.     

Palmoplantar hyperkeratosis associated with losartan

Losartan belongs to the group of angiotensin II receptor antagonists and is used for the treatment of hypertension and heart failure. It acts in the renin angiotensin system (RAS) by blocking the angiotensin II receptor. There have been several reports on cutaneous side events by angiotensin antagonists due to their effect on the local cutaneous RAS. We review the case of palmoplantar lesions that developed in a patient taking losartan and the subsequent remission after treatment withdrawal. Since these reactions are being increasingly reported and as they can mimic a broad variety of classical skin disorders, they should be considered as the cause of sudden, inexplicable skin eruptions in patients taking angiotensin receptor antagonists.