TY - JOUR T1 - Treatment of Scleredema Diabeticorum with Tamoxifen JF - The Journal of Rheumatology JO - J Rheumatol SP - 2636 LP - 2637 DO - 10.3899/jrheum.100561 VL - 37 IS - 12 AU - SABRI H. ALSAEEDI AU - PETER LEE Y1 - 2010/12/01 UR - http://www.jrheum.org/content/37/12/2636.abstract N2 - To the Editor:Scleredema, originally described by Buschke in 19021, is a rare sclerodermatosis of unknown etiology, characterized by nonpitting induration of the skin. In general, scleredema first affects the face and neck, and then may spread symmetrically to the shoulders, trunk, arms, and legs. Cardiac and other organ involvement is rare but restrictive lung disease can be a manifestation.Three clinical groups of scleredema have been described by Graff2. In the first group, the disease starts abruptly after an acute upper respiratory tract infection, often with streptococcal pyogenes and having a tendency to resolve after a period of months to years. The second group begins insidiously without a preceding respiratory tract infection, is of longer duration, and persisting over a period of several years. The third group, known as scleredema diabeticorum (SD), is a chronic form of scleredema associated with severe, often complicated, diabetes mellitus (DM).SD is characterized by an insidious onset of skin thickening, occurring diffusely over the posterior neck and upper back and occasionally extending to the deltoid and lumbar regions (Figure 1)3. It has been reported to occur in 2.5% to 14% of all patients with diabetes. Although numerous treatments have been tried, none have been reported to be effective. We describe 2 cases of SD that showed marked clinical regression following treatment with tamoxifen (tamoxifen citrate).Figure 1. Skin thickening and hyperpigmentation on the back and extending forward to involve the shoulders and chest in a patient with scleredema diabeticorum not treated with tamoxifen. A 61-year-old Chinese woman presented to our Scleroderma Clinic in April 2002 with a 2-year history of progressive skin thickening involving her back, chest, and shoulders but sparing her extremities. There was tightness of her chest with restricted movement of her shoulders, especially with reaching … Address correspondence to Dr. S. AlSaeedi, Mount Sinai Hospital, The Rebecca MacDonald Centre for Arthritis and Autoimmune Disease, 60 Murray Street, Box 9, Rm 2-004, Toronto, Ontario M5T 3L9, Canada. E-mail: sa2005saa{at}hotmail.com ER -