Scleroedema adultorum of Buschke is a rare disorder characterized by fibromucinous thickening of the dermis that manifests mainly at the nape of the neck and on the upper back and shoulders. This study screened patients with diabetes mellitus for skin hardening caused by scleroedema adultorum of Buschke and characterized the clinical and laboratory findings in patients with newly identified cases, with a focus on lipid metabolism abnormalities and vascular complications. Out of 113 consecutive patients with diabetes, 11 (9.7%) new scleroedema patients, all with type 2 diabetes, were found. Their clinical and laboratory data were compared to those of the rest of the screened patients and to those of a cohort of 15 patients with scleroedema and diabetes who were already being treated in a tertiary clinical centre at the University of Pécs. Higher proportions of patients with dyslipidaemia, hypertriglyceridemia (P < 0.05) and increased mean levels of non-high-density lipoprotein cholesterol (non-HDL-C) were found (P < 0.01) in both scleroedema groups than in the group without scleroedema. Stroke and venous thromboembolism (VTE) were more frequently found in the histories of both the newly identified scleroedema group (each 3/11; 27.3%) and the treated cohort (each 6/15; 40.0%) than in the group without scleroedema (6/102; 5.9% in cases of stroke P = 0.021, P < 0.001; and 14/102; 13.7%; P < 0.05 in cases of VTE, respectively). Based on binary logistic regression, a high non-HDL-C level (odds ratio (OD): 3.338, confidence interval (CI): 1.77–6.28; P < 0.001) and insulin treatment (OR 7.64, CI 1.9–29.3; P = 0.003) were independent predictors of scleroedema in patients with diabetes mellitus. Diabetes patients with scleroedema had more severe dyslipidaemia and higher occurrence of vascular complications compared to those without scleroedema. In addition to poorly controlled type 2 diabetes mellitus requiring insulin treatment, high non-HDL-C levels may be another contributing factor to the development of scleroedema. NCT04335396 .

中文翻译：

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筛查糖尿病患者是否存在 Buschke 成人硬化性水肿：新诊断患者的血脂异常患病率较高

Buschke 成人硬化性水肿是一种罕见的疾病，其特征是真皮纤维粘液性增厚，主要表现在颈背、上背部和肩部。本研究筛查了糖尿病患者是否存在由 Buschke 成人硬化性水肿引起的皮肤硬化，并对新确诊病例的临床和实验室检查结果进行了表征，重点关注脂质代谢异常和血管并发症。在 113 名连续的糖尿病患者中，发现了 11 名（9.7%）新的硬化性水肿患者，全部患有 2 型糖尿病。他们的临床和实验室数据与其他接受筛查的患者以及 15 名已经在佩奇大学三级临床中心接受治疗的硬化性水肿和糖尿病患者的数据进行了比较。与无硬化性水肿组相比，两个硬化性水肿组的血脂异常、高甘油三酯血症 (P < 0.05) 和非高密度脂蛋白胆固醇 (non-HDL-C) 平均水平升高 (P < 0.01) 的患者比例更高。中风和静脉血栓栓塞 (VTE) 在新发现的硬化性水肿组（各占 3/11；27.3%）和治疗组（各占 6/15；40.0%）的病史中比在没有硬水肿的组中更常见（ 6/102；中风病例为 5.9% P = 0.021，P < 0.001；和 14/102；13.7%；VTE 病例分别为 P < 0.05）。基于二元逻辑回归，高非 HDL-C 水平（优势比 (OD)：3.338，置信区间 (CI)：1.77–6.28；P < 0.001）和胰岛素治疗（OR 7.64，CI 1.9–29.3；P = 0。003) 是糖尿病患者硬化性水肿的独立预测因子。与无硬化性水肿的糖尿病患者相比，有硬化性水肿的糖尿病患者血脂异常更严重，血管并发症的发生率更高。除了需要胰岛素治疗的控制不佳的 2 型糖尿病之外，高非 HDL-C 水平可能是导致硬性水肿发展的另一个因素。NCT04335396。