INDURATION

The term induration refers to a feeling of thickness and firmness of the skin.

Infant/Child

Congenital Fascial Dystrophy. Indurated skin beginning in infancy from thickened fascia is characteristic.

Phenylketonuria. Localized induration appears first in the muscles and skin of the thighs and buttocks with onset within the first year of life.

Progeria. Indurated plaques in an infant can be a presenting sign of progeria [PD 1990;7;314].

Restrictive Dermopathy

Scleredema In A Child. Acquired diffuse induration of a child with mucopolysaccharides in the dermis is characteristic of this disease. It may be preceded by a Streptococcal infection [AD 1986;122;1419].

Sclerema Neonatorum. A premature infant in poor health with indurated, yellow skin is characteristic. The palms, soles and genitalia may be spared.

Sclerotic Regressing Large Congenital Nevus

Adult, Diffuse

General Workup

The general workup for diffuse, acquired induration of the skin should include a search for acrosclerosis, Raynaud's phenomenon, ANA, etc.

Common

Scleroderma
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Scleredema Diabeticorum. Induration of the upper back in a patient with diabetes.
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Eosinophilic Fasciitis

Uncommon

Graft vs. Host Disease

POEMS Syndrome

Eosinophilia-Myalgia Syndrome

Scleredema Of Buschke/Infection

Scleredema Of Buschke/Paraprotein

Carcinoid Syndrome. Rarely, diffuse cutaneous sclerosis may develop in advanced metastatic carcinoid syndrome [CED 1994;19;83].

Cutaneous T-Cell Lymphoma. Rarely, T-cell lymphoma may present with skin sclerosis that resembles systemic sclerosis [Dermatology 1999;198;75].

Primary Systemic Amyloidosis. Rarely, patients with primary systemic amyloidosis may develop diffuse sclerosis of the skin resembling scleroderma (aka scleroderma amyloidosum) [BJD 1999;140;1169].

Nephrogenic Systemic Fibrosis

Indurated Plaques Associated with Renal Failure

Adult, Localized

Borrelia. Juxta-articular and juxta-osseous fibrosis as well as localized or widespread fibrotic lesions have occurred in association with Borrelia Burgdorferi infection [BJD 1993;128;674].

Graft vs. Host Disease. Localized induration of the skin, non-inflammatory, with subcutaneous edema has been seen in association with GvHD.

Lupus Erythematosus Profundus

Morphea

Porphyria Cutanea Tarda

Vitamin K Injection Reaction [AD 1985;121;1421]

Linear

Linear Scleroderma
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Post-Stripping Sclerodermiform Dermatitis

Drug-Induced

Taxane-induced Scleroderma

Pentazocine-Induced Woody Induration


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