Scleromyxoedema: the importance of physical examination

A 43-year-old previously healthy man presented for a first medical appointment at our immunology clinic with a 1 year history of painless nose and ear oedema and erythema, with no other symptoms. He had been diagnosed with relapsing polychondritis after laboratory studies revealed normal inflammatory markers, and was unsuccessfully treated with systemic corticosteroids, along with methotrexate in the last 3 months of treatment. Physical examination revealed deep furrows of the glabella (figure 1), skin thickening of the glabella, nose and ears with ear lobe involvement (figures 1 …