History: Scleredema of Buschke is characterized by thickening and stiffening of the skin particularly over the upper back and the chest.It is seen most often in diabetics.There is usually no involvement of the hands such as you would see in scleroderma.Some cases occur following an upper respiratory viral infection.These cases will remit in 6 months or so but other cases may persist for years.Mucin is seen in the skin in early cases but is replaced by fibrosis later.Occassionaly an IgG paraprotein is found in the blood.