Usefulness of high-frequency Doppler ultrasound skin thickness measurement for disease staging and assessing treatment response in patients with scleredema: A case-control study

Abstract

To the Editor: Scleredema, a rare disease characterized by increased collagen and mucin deposits in the dermis, has been associated with diabetes mellitus, monoclonal gammopathy, and infections.1 The thickness of the dermis in the back can even be multiplied 3- to 4-fold, mainly because of acid mucopolysaccharides deposition.1 The course is unpredictable, with surprising abrupt resolutions or dull persistence for years. The diagnosis is often delayed for months or years.2 Increased body volume due to obesity can simulate the skin's stiffness and thickening in patients with scleredema and delay the diagnosis.