title: Scleredema Diabeticorum with unusual presentation and fatal outcome.
abstract: We present a case of Scleredema Diabeticorum (SD) in a patient with diabetic neuropathy and restrictive respiratory disease with unusual skin lesion distribution. The onset of dermatologic symptoms heralded a progressive respiratory disease with constrictive component. Painful diabetic neuropathy was noteworthy and difficult to relieve. Predominantly, distribution of the skin lesions on the thighs makes the case exceptional. T2-weighted MRI showed abnormal hyperintensities along the muscles of the thighs in correspondence with the skin lesions. Gait and respiratory symptoms progressively worsened. After a transient remitting period, he developed sudden shortening of breath, arrested and expired at home.The atypical distribution of the skin lesions with further involvement of underlying muscles plus concomitant polyneuropathy and respiratory constrictive disease with sudden death is quite unusual and aggressive presentation of SD.
authors.affiliation: Department of Neurology, Hamad General Hospital, Doha, State of Qatar. fruizelo@gmail.com
authors.forename: Francisco J Ruiz
authors.initials: FJ
authors.lastname: Miyares
authors.forename: Renju
authors.initials: R
authors.lastname: Kuriakose
authors.forename: Dirk T
authors.initials: DT
authors.lastname: Deleu
authors.forename: Naghi Abd
authors.initials: NA
authors.lastname: El-Wahad
authors.forename: Hassan
authors.initials: H
authors.lastname: Al-Hail