Facial Swelling in a Young Adult With Type 1 Diabetes: Morbihan Disease as a Scleroderma Mimic

TL;DR

A young man with type 1 diabetes developed facial swelling resembling scleroderma, but it was actually Morbihan disease, highlighting the importance of accurate diagnosis.

Contribution

This case highlights Morbihan disease as a rare mimic of scleroderma in patients with type 1 diabetes.

Findings

Facial swelling in a type 1 diabetes patient was diagnosed as Morbihan disease, not scleroderma.

Histopathology suggested scleredema diabeticorum or Morbihan disease secondary to rosacea.

Diagnostic exclusion of superior vena cava syndrome and connective tissue diseases was critical.

Abstract

Scleredema diabeticorum and Morbihan disease (solid facial edema) can mimic scleroderma, creating diagnostic challenges for rheumatologists. We report a 19-year-old male with poorly controlled type 1 diabetes (glycated hemoglobin (HbA1c) >9%) presenting with progressive facial swelling. Extensive workup excluded superior vena cava syndrome and connective tissue diseases. Histopathological examination of the skin fragment was suggestive of scleredema diabeticorum or Morbihan disease secondary to rosacea. Key differentiating features included sparing of hands/feet, absence of Raynaud's phenomenon, and non-specific low-titer anti-nuclear antibody (ANA). This case emphasizes recognizing scleroderma mimics to ensure appropriate therapy.

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