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There are three types of scleredema, a type of cutaneous mucinosis of unknown cause. Scleredema should not be confused with ‘scleroderma', in which the skin is fibrotic (morphoea and systemic sclerosis).

Scleredema presents with symmetrical hardening and thickening of the dermal or middle layer of the skin with mucin deposits between collagen bundles. The diagnosis is confirmed by skin biopsy.

The affected areas are firm and woody plaques, sometimes slightly red or brown and often with a ‘peau d'orange' (orange-skin) appearance. The face may appear expressionless and there can be difficulty opening the mouth.

All three types of scleredema can restrict movement but otherwise seldom have serious consequences. Occasionally swallowing and speech can be affected and other organs involved - the eyes, tongue, parotid gland, muscles, joints and heart.

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