case_images: PMC9880447_01
case_images: (A-C) Cutaneous manifestations before IVIG treatment; (D, E) after six courses of IVIG treatment. IVIG, high-dose intravenous immunoglobulin.
case_images: fimmu-13-1099918-g001.jpg
case_images: PMC9880447_01_fimmu-13-1099918-g001.jpg
case_images: f1
case_images: Diffuse, skin-colored, 2- to 3-mm, firm, and waxy papules in a linear arrangement coalesced into indurated plaques over the trunk and extremities ( Figures 1A-C ). She tolerated this treatment well and her skin symptoms and muscle weakness, dysphagia, and fatigue were significantly improved after six cycles of treatment ( Figures 1D, E ).
case_images: (A) Histopathology of scleromyxedema with the typical triad of mucin, fibroblast proliferation, and fibrosis; (B) alcian blue staining was positive in the upper and mid dermis.
case_images: fimmu-13-1099918-g002.jpg
case_images: PMC9880447_01_fimmu-13-1099918-g002.jpg
case_images: f2
case_images: A skin biopsy found evidence of irregular fibrosis and fibroblast proliferation with interstitial mucin deposits ( Figure 2A ). Alcian blue staining was positive in the upper and mid dermis ( Figure 2B ).