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Alexander Kreuter, MD
Section Editor
Jeffrey Callen, MD, FACP, FAAD
Deputy Editor
Abena O Ofori, MD


Scleredema (synonym: scleredema adultorum of Buschke) is a sclerotic skin disease that usually occurs in association with diabetes mellitus, infection (particularly streptococcal infection of the upper respiratory tract), or monoclonal gammopathy. Scleredema is characterized by the development of diffuse, woody induration of the skin and primarily affects the upper body (picture 1A-C).

The clinical course of scleredema varies from spontaneous resolution within several months, which often occurs in scleredema that follows a streptococcal upper respiratory infection, to persistent disease. Data on the treatment options for scleredema are primarily limited to case reports; therefore, the best approach to treatment remains unclear.

The clinical features, diagnosis, and management of scleredema will be discussed here. Other sclerotic disorders of the skin, such as systemic sclerosis (scleroderma) and scleromyxedema are distinct from scleredema. Overviews of these disorders are provided separately. (See "Overview of the clinical manifestations of systemic sclerosis (scleroderma) in adults" and "Scleromyxedema".)


The German dermatologist Abraham Buschke (1868–1943) has been credited with the first description of scleredema [1]. However, it seems that the original report can be traced to a description by Pitford in 1876.

The exact prevalence of scleredema is not known. Although scleredema is generally considered a rare disorder, the possibility that scleredema is underrecognized is suggested by a prospective study of 484 patients with diabetes in California that found a prevalence of scleredema of 2.5 percent [2]. A smaller Kuwaiti study found an even higher prevalence of scleredema in diabetic patients; among 100 patients with diabetes, scleredema was diagnosed in 14 percent [3].


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Literature review current through: Sep 2016. | This topic last updated: Dec 4, 2015.
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