Scleroedema adultorum bei sekundärem Hyperparathyreoidismus

Abstract

Scleredema adultorum, or Buschke's scleredema, belongs to the group of mucinoses. It is characterised by thickened and indurated skin. Histopathology shows thickened dermis with an infiltration of mucin between swollen collagen bundles. There are reports about many associations with scleredema adultorum, e.g., with diabetes mellitus and multiple myeloma. One case is known with associated primary hyperparathyroidism. For the first time we report a case of scleredema adultorum and secondary hyperparathyroidism, in a 46-year-old patient. Both forms of hyperparathyroidism have increased levels of parathormone. Therefore, these increased levels could have an influence on collagen metabolism.

Scleredema adultorum associated with type 2 diabetes mellitus: a report of three cases

“…2). 4,8,9 The same histological findings were detected in specimens from the other two patients. Because of the short history of her disease the patient was treated with intravenous penicillin (3 × 5 million U/day) for 2 weeks despite the absence of clinical signs of infection.…”

“…Moreover, multiple organs can be involved with respective complications. Skin induration of the whole trunk may result in restrictive pulmonary disease 4,7–9 . The disease occurs at all ages and in all ethnicities.…”

“…Three types of scleredema adultorum are differentiated 4,7,8 . Type 3 scleredema is associated with diabetes mellitus, usually poorly controlled insulin‐dependent type 2 diabetes.…”

European dermatology forum S1-guideline on the diagnosis and treatment of sclerosing diseases of the skin, Part 2: Scleromyxedema, scleredema and nephrogenic systemic fibrosis

“…Type 3 (20%) was named scleredema diabeticorum by Krakowski and colleagues because of its strict association with diabetes mellitus. Other associated diseases include primary hyperparathyroidism, rheumatoid arthritis, ankylosing spondylitis, Sjögren's syndrome, dermatomyositis, Waldenström's macroglobulinemia, anaphylactoid purpura, primary biliary cirrhosis and IgA deficiency . Cases of concomitant neoplasms have been reported, such as malignant insulinoma, gall bladder carcinoma, carcinoid tumour and adrenocorticotropic hormone‐producing pituitary tumour .…”

Hautveränderungen bei Diabetes mellitus

“…Bei Erwachsenen wird eine mehrfache intraläsionale Anwendung einer Triamcinolonacetonid-Kristallsuspension (verdünnt mit Lokalanästhetika) empfohlen oder ein Okklusivverband mit fluorierten Glukokortikoid-Salben. Eine weitere Alternative mit guter Wirksamkeit ist die lokale PUVA-Creme-Therapie[27,28,29,30,31].Hautkomplikationen als Ausdruck einer Folgeerkrankung des Diabetes mellitus findet man hauptsächlich beim 7 diabetischen Fußsyndrom. Hier sei auf Heft 2, 2009, der Zeitschrift Der Diabetologe hingewiesen, daher hier nur eine kurze Abhandlung.…”