You are correct. Scleroedema, a cutaneous mucinosis, can occur secondary to acute streptococcal throat infection, paraproteinaemia, or DM. The last of these, termed scleredema diabeticorum, is thought to be due to glycosylation of collagen in the dermis leading to an excessive accumulation of collagen and mucin. This patient, who had a raised hemoglobin A1c concentration of 8.9% and serum protein electrophoresis within reference limits, was treated with metformin for glycemic control. After 6 months both his hemoglobin A1c concentration and cutaneous lesions had improved.

BMJ 2024;384:e075940