Scleredema is a rare connective tissue disorder characterized by diffuse, nonpitting edema and skin induration spreading from the neck region to the trunk and upper limbs. In diabetic patients without preceding infections or other skin disorders, it is diagnosed as diabetic scleredema after excluding other skin disorders such as scleroderma. We encountered two cases of scleredema: one managed with observation due to poor diabetes control and one managed with surgical excision. The symptoms remained unchanged in the first case, but the second case achieved a favorable outcome without recurrence. The diagnosis was confirmed by pathological findings, as there are no specific imaging findings for this disease. A tissue biopsy should be proactively considered if this disease is suspected. To the best of our knowledge, there are no reports for surgical excision for scleredema. Our findings suggest that surgical treatment may be viable, as one of our cases achieved functional and morphological improvements following excision.
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