# Scleromyxedema Managed With High‐Dose Intravenous Immunoglobulin and Bortezomib–Dexamethasone: A Case Report

**Authors:** Darren Wijaya, Zachary Hanson, Eric K. Lau, Mojtaba Akhtari

PMC · DOI: 10.1155/crom/3773160 · 2026-02-26

## TL;DR

A 48-year-old woman with scleromyxedema showed significant improvement using a combination of high-dose immunoglobulin and bortezomib-dexamethasone, with maintenance therapy preventing relapse.

## Contribution

This case report presents a successful treatment approach combining HDIVIG and bortezomib–dexamethasone for scleromyxedema.

## Key findings

- Partial response to high-dose intravenous immunoglobulin (HDIVIG) was observed.
- Significant clinical improvement occurred with bortezomib and dexamethasone.
- Long-term maintenance with IVIG prevented symptom recurrence.

## Abstract

Scleromyxedema is a rare, chronic cutaneous mucinosis marked by widespread waxy papules and potential extracutaneous involvement. This case report discusses the management of a 48‐year‐old female diagnosed with scleromyxedema, who initially partially responded to high‐dose intravenous immunoglobulin (HDIVIG) therapy. After partial relapse, she was induced with bortezomib, a proteasome inhibitor, and dexamethasone, achieving significant clinical improvement. Long‐term maintenance with IVIG was utilized to prevent recurrence of symptoms. This case highlights the effectiveness of both HDIVIG and bortezomib–dexamethasone dual therapy as viable treatment options for scleromyxedema, emphasizing the importance of maintenance therapy to prevent relapse.

## Linked entities

- **Chemicals:** bortezomib (PubChem CID 387447), dexamethasone (PubChem CID 5743)
- **Diseases:** scleromyxedema (MONDO:0015665)

## Full-text entities

- **Genes:** TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}, GFAP (glial fibrillary acidic protein) [NCBI Gene 2670] {aka ALXDRD}, BTG3 (BTG anti-proliferation factor 3) [NCBI Gene 10950] {aka ANA, ANA/BTG3, APRO4, TOB5, TOB55, TOFA}, ALB (albumin) [NCBI Gene 213] {aka FDAHT, HSA, PRO0883, PRO0903, PRO1341}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, MUC1 (mucin 1, cell surface associated) [NCBI Gene 4582] {aka ADMCKD, ADMCKD1, ADTKD2, CA 15-3, CD227, Ca15-3}, B3GAT1 (beta-1,3-glucuronyltransferase 1) [NCBI Gene 27087] {aka CD57, GLCATP, GLCUATP, HNK1, LEU7, NK-1}, IL1A (interleukin 1 alpha) [NCBI Gene 3552] {aka IL-1 alpha, IL-1A, IL1, IL1-ALPHA, IL1F1}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, SMN1 (survival of motor neuron 1, telomeric) [NCBI Gene 6606] {aka BCD541, GEMIN1, SMA, SMA1, SMA2, SMA3}, CD34 (CD34 molecule) [NCBI Gene 947], mucin [NCBI Gene 100508689], F13A1 (coagulation factor XIII A chain) [NCBI Gene 2162] {aka F13A}, ENO2 (enolase 2) [NCBI Gene 2026] {aka HEL-S-279, NSE}
- **Diseases:** monoclonal gammopathies (MESH:D010265), joint stiffness (MESH:C535724), Rheumatologic (MESH:D012216), arthralgias (MESH:D018771), pericarditis (MESH:D010493), arthritis (MESH:D001168), anemia (MESH:D000740), tendon involvement (MESH:D052256), encephalopathy (MESH:D001927), skin abnormalities (MESH:D012868), heart failure (MESH:D006333), Cardiac involvement (MESH:D006331), constipation (MESH:D003248), peripheral neuropathy (MESH:D010523), Scleromyxedema (MESH:D053718), Tumor (MESH:D009369), chronic cutaneous mucinosis (MESH:D017520), diverticulitis (MESH:D004238), Neurologic complications (MESH:D002493), asthma (MESH:D001249), fibrosis (MESH:D005355), headaches (MESH:D006261), dysphonia (MESH:D055154), skin condition (MESH:D012871), DNS (MESH:D013577), cervical cancer (MESH:D002583), pain (MESH:D010146), systemic sclerosis (MESH:D012595), pruritus (MESH:D011537), myocardial infiltration (MESH:D017254), arrhythmias (MESH:D001145), hair loss (MESH:D000505), rash (MESH:D005076), pruritic (MESH:C535817), cardiomyopathy (MESH:D009202)
- **Chemicals:** Dexamethasone (MESH:D003907), melphalan (MESH:D008558), HDIVIG (-), T4 (MESH:D013974), glycosaminoglycan (MESH:D006025), gabapentin (MESH:D000077206), steroids (MESH:D013256), vitamin B12 (MESH:D014805), zinc (MESH:D015032), Bortezomib (MESH:D000069286), testosterone (MESH:D013739)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12943466/full.md

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Source: https://tomesphere.com/paper/PMC12943466