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Scleredema diabeticorum complicated with acanthosis nigricans
Pages: 443-445
Year: Issue:  7
Journal: Journal of Clinical Dermatology

Keyword:  scleredema diabeticorumacanthosis nigricans;
Abstract: A case of scleredema diabeticorum(SD) complicated with acanthosis nigricans(AN) is reported. A 33-yearold man presented with skin thickening and hyperpigmentation in body folds for 5 years, and skin on his back became hardening for 1 year. The patient had a history of type 2 diabetes, and received traditional Chinese medicine with no response.Physical examination revealed dark-brown velvety patches on the nape of the neck, axillae and groins. There was a brown pigmented, non-pitting edematous indurated plaque sized 16 cm×15 cm, with undefined borders, on the right-upper back.Histopathological examination showed epidermal hyperkeratosis, papillomatous proliferation and hyperpigmentation in the basal layer. The valleys between the dermal papillae were mild acanthosis and filled with keratotic materials. The thickened dermis with a few melanophages and slight perivascular lymphocytic infiltrate in the upper dermis were seen. Swollen collagen bundles were separated in the deep dermis. The subcutaneous fat was replaced by collagen fibers. Alcian blue staining revealed mucin deposition between the collagen bundles in the deep dermis. The final diagnosis was SD complicated with AN. The patient was given no specific therapy, but skin lesions remained unchanged during about 2 years of follow-up.
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