We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
The Cutting Edge: Challenges in Medical and Surgical Therapies |

Successful Treatment of Poststreptococcal Scleredema Adultorum Buschke With Intravenous Immunoglobulins

Maximilian C. Aichelburg, MD; Robert Loewe, MD; Nikolaus Schicher, MD; Paul-Gunther Sator, MD; Franz M. Karlhofer, MD; Georg Stingl, MD; Ahmad Jalili, MD, PhD
Arch Dermatol. 2012;148(10):1126-1128. doi:10.1001/archdermatol.2012.1558.
Text Size: A A A
Published online


We report a case of rapidly progressing poststreptococcal scleredema adultorum Buschke (SAB) that successfully responded to treatment with intravenous immunoglobulins (IVIGs).

Correspondence: Ahmad Jalili, MD, PhD, Division of Immunology, Allergy, and Infectious Diseases, Department of Dermatology, Medical University of Vienna, General Hospital (AKH), Währinger Gürtel 18-20, A-1090 Vienna, Austria (ahmad.jalili@meduniwien.ac.at).

Accepted for Publication: April 7, 2012.

Author Contributions: All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Aichelburg, Sator, and Jalili. Acquisition of data: Aichelburg, Loewe, Schicher, Sator, Karlhofer, and Jalili. Analysis and interpretation of data: Aichelburg, Loewe, Sator, Stingl, and Jalili. Drafting of the manuscript: Aichelburg and Jalili. Critical revision of the manuscript for important intellectual content: Aichelburg, Loewe, Schicher, Sator, Karlhofer, Stingl, and Jalili. Statistical analysis: Aichelburg and Jalili. Obtained funding: Sator. Administrative, technical, and material support: Loewe and Sator. Study supervision: Aichelburg, Karlhofer, Stingl, and Jalili.

Financial Disclosure: None reported.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Graphic Jump Location

Figure 1. Substantial improvement in skin sclerosis as seen by the reappearance of skin folds (A and C) and shoulder abduction (B and D) after 5 cycles of intravenous immunoglobulin administration. The patient is shown before (A and B) and after (C and D) treatment with intravenous immunoglobulins.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 2. Histologic manifestation of scleredema adultorum Buschke. Marked sclerosis of the dermis with greatly thickened reticular dermis and lymphocytic infiltration (A) (hematoxylin-eosin, original magnification ×20) and swollen separated collagen bundles replaced by mucin deposits (B) (alcian blue, original magnification ×40).

Place holder to copy figure label and caption
Graphic Jump Location

Figure 3. Significant reduction of the skin thickness in the upper arm area and neck confirmed by sonographic imaging after 5 cycles of intravenous immunoglobulins. Unpaired t test, P < .05 is considered significant.




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

2 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles