Pseudoscleroderma L94.8

Polyetiologic, chronic inflammatory disease of variable etiology that may be associated with superficial or deep sclerosis of the dermis and/or subcutis, as well as internal organs.

The disease symptoms may show clinical-morphological signs of circumscritic scleroderma or systemic scleroderma, thus mimicking them. The most common case of pseudoscleroderma is indurations in chronic venous insufficiency, CVI .

According to etiology, one distinguishes:

• Infectious causes:
  • Lyme disease.
• Drug- or toxin-induced:
  • Toxic oil syndrome
  • Eosinophilic myalgia syndrome (L-tryptophan)
  • Epoxy resins
  • Pseudoscleroderma due to drugs: phenobarbital, D-penicillamine, gold preparations, hepatitis B vaccine, captopril, spironolactone, allopurinol, bleomycin, doxetaxel, cisplatin, pentazocine, (centrally acting analgesic), cocaine, appetite suppressants
• Metabolic-induced:
  • Scleroedema adultorum
  • Scleromyxedema
  • Amyloidosis
  • Porphyria cutanea tarda ( scleroporphyria)
  • Phenylketonuria
  • Mucopolysaccharidoses
  • Scleroderma-like skin changes in diabetes mellitus
  • Necrobiosis lipoidica.
• Foreign material-induced:
  • Silicone or kerosene implants(?)
  • Polyvinyl chloride disease
  • Nephrogenic systemic fibrosis.
• Congestive syndromes:
  • Dermatoliposclerosis in CVI
  • Dermatosclerosis in lymphedema.
• Idiopathic- or immunologic-induced:
  • Progeria adultorum (Werner syndrome)
  • Progeria infantilis
  • Fasciitis, eosinophilic
  • Sclerofascia
  • Fibrosis, oral submucosal
  • Graft-versus-host disease, chronic
  • Fibrosis, nephrogenic systemic (Nephrogenic fibrosing dermopathy)
  • Stiff-skin syndrome
• Paraneoplastic-induced:
  • Bronchial carcinoma
  • Metastatic carcinoid
  • Immunocytic lymphoma.
• Physically induced:
  • Scleroderma-like changes in radiatio of breast carcinoma.
• Psychogenically induced:
  • See below Psychosomatics.

1. Barth J, Kleemann W (1972) Pseudoscleroderma in silicosis. Z Skin Sexkr 47: 123-134
2. Behrens S et al (1998) Bleomycin-induced PSS-like pseudoscleroderma. Case report and review of the literature. dermatologist 49: 725-729
3. Bretza J, Goldman JA (1979) Scleroderma simulating vinyl chloride disease. J Occup Med 21: 436-438
4. Fabris M, Hunzelmann N (2007) Differential diagnosis of scleroderma and psuedoscleroderma. JDDG11:977-984
5. Fujii T et al (2003) Pseudoscleroderma associated with transforming growth factor beta1-producing advanced gastric carcinoma: comment on the article by Varga. Arthritis Rheum 48: 1766-1767
6. Gray RG, Gottlieb NL (1981) Pseudoscleroderma in hypertrophic osteoarthropathy. JAMA 246: 2062-2063
7. Guillet GY et al (1983) Pseudoscleroderma and phenylketonuria. Int J Dermatol 22: 422-426
8. Haustein UF (1992) Chemically induced scleroderma. dermatologist 43: 469-474
9. Jablonska S (1967) Pseudoscleroderma. Med Small 62: 1151-1154
10. Jung AG et al (2010) Unusual chronic scleroderma graft-versus-host disease. dermatologist 61: 514-517
11. Pang BK et al (1996) Pseudoscleroderma secondary to phytomenadione (vitamin K1) injections: Texier's disease. Australas J Dermatol 37: 44-47
12. Querfeld C et al (2000) Pseudoscleroderma associated with lung cancer: correlation of collagen type I and connective tissue growth factor gene expression. Br J Dermatol 142: 1228-1233
13. Roses RM (1992) Localized scleroderma and Borrelia antibody seroconversion. Int J Dermatol 31: 820
14. Takagawa S et al (2003) Sustained activation of fibroblast transforming growth factor-beta/Smad signaling in a murine model of scleroderma. J Invest Dermatol 121: 41-50
15. Yamamoto T, Nishioka K (2002) Analysis of the effect of halofuginone on bleomycin-induced scleroderma. Rheumatology (Oxford) 41: 594-596
16. Yamamoto T et al (2001) Mast cell-independent increase of type I collagen expression in experimental scleroderma induced by bleomycin. Arch Dermatol Res 293: 532-536
17. Yamamoto T, Nishioka K (2002) Animal model of sclerotic skin. V: Increased expression of alpha-smooth muscle actin in fibroblastic cells in bleomycin-induced scleroderma. Clin Immunol 102: 77-83
18. Yamamoto T, Nishioka K (2003) Role of monocyte chemoattractant protein-1 and its receptor, CCR-2, in the pathogenesis of bleomycin-induced scleroderma. J Invest Dermatol 121: 510-516
19. Yamamoto T et al (2002) Analysis of the effect of halofuginone on bleomycin-induced scleroderma. Rheumatology (Oxford) 41: 594-596