Unveiling the enigma: a case-based review of scleromyxedema

Scleromyxedema is a rare chronic fibromucinous disorder characterized by a generalized papular and sclerodermoid eruption. Despite its clinical significance, no definitive therapeutic guidelines exist for scleromyxedema, making management challenging. Herein, we present a case of a 76-year-old female patient referred for evaluation of systemic sclerosis, presenting with distinctive cutaneous manifestations and neurological symptoms. Investigations revealed monoclonal gammopathy (IgG Lambda subtype) and antinuclear antibodies, supporting a diagnosis of scleromyxedema. A multidisciplinary approach with intravenous immunoglobulin (IVIG) therapy resulted in significant improvement in neurological and cutaneous symptoms. This case underscores the challenges of diagnosing and managing scleromyxedema and highlights IVIG as a potential therapeutic option in the absence of standardized guidelines.