Scleroderma-like changes in a patient with insulin-dependent diabetes mellitus

A 38-year-old Japanese woman with diabetes showed sclerosis of the hands, a short sublingual frenulum, and hypomotility of the esophagus. She had been on insulin therapy for insulin-dependent diabetes mellitus since the age of 15. For the previous one year, the proximal interphalangeal joints had become painful and swollen with sclerosis of the hands. Although these findings are also seen in PSS, this case was assumed to be due to diabetes mellitus. The patient had a high serum level of HbA1c, which may reflect a poor control of diabetes and non-enzymatic glycosylation of collagen fibers, resulting in an accumulation of collagen in the dermis.