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[Buschke's scleredema and carditis: a clinical case]
La Pediatria Medica E Chirurgica : Medical and Surgical Pediatrics
|November 1, 1982
Summary
Scleredema of Buschke, a rare skin condition, can present with cardiac complications like arrhythmias and heart failure in children. Prompt diagnosis and management are crucial for favorable outcomes.
Area of Science:
- Pediatrics
- Dermatology
- Cardiology
Background:
- Scleredema of Buschke is a rare connective tissue disorder characterized by indurated edema of the skin.
- It typically affects adults but can occur in children, sometimes following an infection.
Observation:
- An 11-year-old girl presented with facial and neck edema, shoulder pain, and a gallop rhythm post-febrile illness.
- Clinical presentation suggested scleredema, potentially with carditis.
- Skin and muscle biopsies confirmed scleredema of Buschke.
Findings:
- Cardiac involvement included persistent gallop rhythm, ECG abnormalities (T-wave inversion), pericardial friction rub, and hepatomegaly due to right-sided heart failure.
- Elevated antistreptolysin O (ASLO) titer and cardiac findings initially suggested acute rheumatic fever.
- Differential diagnoses included dermatomyositis and scleroderma.
Implications:
- This case highlights the importance of considering scleredema in pediatric patients with unusual edema and systemic symptoms.
- Cardiac involvement in scleredema requires careful monitoring and management.
- Complete resolution of edema and cardiac symptoms was observed within 12 months, indicating a generally favorable prognosis with appropriate care.