Metabolic skin signs: scleredema adultorum: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Metabolic skin signs: scleredema adultorum

Sample item

A man with long-standing poorly controlled diabetes and obesity has diffuse woody, non-pitting thickening of the skin of the upper back and posterior neck. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Scleredema adultorum of Buschke

Scleredema diabeticorum is a mucinous thickening of the upper back and neck seen in diabetes with obesity, without Raynaud, sclerodactyly or visceral fibrosis. Biopsy shows thickened collagen with mucin. Treatment includes glycaemic control and phototherapy.

Option by option

  • A. Eosinophilic fasciitis

    Eosinophilic fasciitis has a groove sign and eosinophilia.

  • B. Morphoea

    Morphoea has well-defined plaques with a lilac border.

  • C. Systemic sclerosis with sclerodactyly

    Systemic sclerosis has Raynaud and sclerodactyly.

  • D. Scleredema adultorum of Buschke (correct)

    Correct. Woody thickening of the upper back in diabetes is scleredema.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is D, Scleredema adultorum of Buschke. Scleredema diabeticorum is a mucinous thickening of the upper back and neck seen in diabetes with obesity, without Raynaud, sclerodactyly or visceral fibrosis.

Why is "Eosinophilic fasciitis" not the answer?

Eosinophilic fasciitis has a groove sign and eosinophilia.

Why is "Morphoea" not the answer?

Morphoea has well-defined plaques with a lilac border.

Why is "Systemic sclerosis with sclerodactyly" not the answer?

Systemic sclerosis has Raynaud and sclerodactyly.

What concept does this question test?

It tests Metabolic skin signs: scleredema adultorum in Dermatology. Biopsy shows thickened collagen with mucin. Treatment includes glycaemic control and phototherapy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Metabolic skin signs: scleredema adultorum?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.