I have just recently been diagnosed with scleredema diabeticorum (Buschke’s disease). It is characterized clinically by woody induration and hardening of the skin that results from excessive mucin deposition between thickened collagen bundles in the skin’s dermis. Scleredema diabeticorum often has a subtle onset, persistent involvement and is refractory to therapies. A case of diffuse sclerederma has been reported in association with a malignant insulinoma, suggesting the possibility that it is the elevated insulin which may cause the skin changes. It is important to differentiate this condition from scleroderma. Her medication included metformin (2000 mg/day) and premixed insulin (50 U/day). Various specific treatments proposed in the literature are poorly validated.
We believe that methotrexate therapy may be an alternative therapeutic options in scleredema in view of its efficacy. 53-year-old white male with type 2 diabetes mellitus was referred to our department