PMC3420415_01
Thickening and erythema of the upper part of the back.
CRIM.ENDOCRINOLOGY2011-560273.001.jpg
PMC3420415_01_CRIM.ENDOCRINOLOGY2011-560273.001.jpg
fig1
The skin of the upper back and posterior neck was erythematous, indurated, and painless (Figure 1) with moderate restriction of range of motion of the shoulders and neck. 
Histological aspect of skin biopsy. Blue Alcian dye. Thickened dermis and increased accumulation of aminoglycans between large collagen bundles.
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PMC3420415_01_CRIM.ENDOCRINOLOGY2011-560273.002.jpg
fig2
Histopathologic study demonstrated thick collagen bundles separated by spaces filled with mucin in the deep reticular dermis, consistent with scleredema adultorum of Buschke (Figure 2).