Scleromyxedema

Page most recently updated 7 September 2026

This page focuses on the reported psychiatric associations, which may be the initial presenting manifestation, and on other clinical features that may assist the psychiatrist or primary care physician in identifying the underlying diagnosis, considered through the lenses of the diagnostic lenses framework.

Scleromyxedema is an immune-mediated mucin deposition disorder characterized by widespread cutaneous mucin accumulation, fibroblast proliferation, and a strong association with monoclonal gammopathy (typically an IgG monoclonal protein), with potential multisystem involvement.

It can present with psychiatric features such as depression, anxiety, cognitive dysfunction, behavioural change, mood disturbance, and, less commonly, psychosis.

Other characteristic features include neurological manifestations such as encephalopathy, cognitive impairment, seizures, peripheral neuropathy, and, rarely, coma. Distinctive features include generalized waxy papules and skin induration due to mucin deposition, associated with monoclonal gammopathy (typically an IgG monoclonal protein).

From a multisystemic lens perspective, clinical features in other body systems include (but are not limited to):

  • Hematologic: monoclonal gammopathy (typically IgG monoclonal protein) is a characteristic association; an underlying plasma cell dyscrasia or other hematologic disorder may occasionally be present.

  • Musculoskeletal: reduced joint mobility, stiffness, and sclerodermoid changes due to skin and connective tissue involvement may occur.

  • Cardiovascular: rare systemic involvement may include cardiac dysfunction or vascular complications.

  • Respiratory: restrictive respiratory symptoms may occur due to skin and connective tissue involvement affecting chest wall mobility.

Early diagnosis is important to enable appropriate evaluation for associated monoclonal gammopathy and systemic complications, initiate disease-specific therapy, prevent progressive functional impairment, reduce the risk of neurological and systemic complications, and improve prognosis and quality of life.

Selected references and further reading — Multisystemic lens

Cardinal RN, Bullmore ET. The diagnosis of psychosis. Cambridge: Cambridge University Press; 2011.

Sachdev PS, Keshavan MS, editors. Secondary schizophrenia. Cambridge: Cambridge University Press; 2010.

Levenson JL, editor. The American Psychiatric Association Publishing textbook of psychosomatic medicine and consultation-liaison psychiatry. 3rd ed. Washington (DC): American Psychiatric Association Publishing; 2019.

Stern TA, Beach SR, Smith FA, Freudenreich O, Vranceau AM, Fava M, editors. Massachusetts General Hospital handbook of general hospital psychiatry. 8th ed. Philadelphia: Elsevier; 2025.

Arciniegas DB, Yudofsky SC, Hales RE, editors. The American Psychiatric Association Publishing textbook of neuropsychiatry and clinical neurosciences. 6th ed. Washington (DC): American Psychiatric Association Publishing; 2018.

Agrawal N, Faruqui R, Bodani M, editors. Oxford textbook of neuropsychiatry. Oxford: Oxford University Press; 2020.

Boland R, Verduin M, editors. Kaplan and Sadock's comprehensive textbook of psychiatry. 11th ed. Philadelphia: Wolters Kluwer; 2024.

Loscalzo J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Harrison's principles of internal medicine. 22nd ed. New York: McGraw Hill; 2025.