PMC9880447_01
(A-C) Cutaneous manifestations before IVIG treatment; (D, E) after six courses of IVIG treatment. IVIG, high-dose intravenous immunoglobulin.
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Diffuse, skin-colored, 2- to 3-mm, firm, and waxy papules in a linear arrangement coalesced into indurated plaques over the trunk and extremities ( Figures 1A-C ). She tolerated this treatment well and her skin symptoms and muscle weakness, dysphagia, and fatigue were significantly improved after six cycles of treatment ( Figures 1D, E ).
(A) Histopathology of scleromyxedema with the typical triad of mucin, fibroblast proliferation, and fibrosis; (B) alcian blue staining was positive in the upper and mid dermis.
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A skin biopsy found evidence of irregular fibrosis and fibroblast proliferation with interstitial mucin deposits ( Figure 2A ). Alcian blue staining was positive in the upper and mid dermis ( Figure 2B ).