A case of scleredema associated with diabetes mellitus

A 66-year-old male complained of thickening of the skin at the face, posterior neck and back after a febrile episode. The patient had obesity, elevated levels of HbA1C and urinary C-peptide. The seological tests for collagen diseases were negative. The serum level of vascular endothelial growth factor (VEGF) was elevated. The biopsied skin specimen revealed the thickening of the dermis by the increased proliferation of collagen fibers, thickening of collagen bundles with fenestrations and infiltration of lymphocytes. Scleredema caused by diabestes mellitus and obesity was diagnosed, accompanied with insulin resistance. The patient was initially treated with administration of prednisolone, followed with diet therapy. Scleredema ameliorated partially, however elevated level of VEGF persisted after 6 months of discharge. It is unclear whether elevated level of VEGF may be related to the pathogenesis of the disease or may be an aggravating factor.

浮腫性硬化症

糖尿病

肥満

本文データは山口大学医学会の許諾に基づきCiNiiから複製したものである