Thalidomide as a Key Therapeutic Agent in a Pediatric Case of Generalized Cutaneous Scleromyxedema

Generalized cutaneous scleromyxedema (GCS) is a rare chronic mucinosis characterized by shiny, firm papules, typically measuring 2–3 mm in diameter, which can appear in a linear distribution. In children, GCS is even rarer and less understood, making treatment particularly challenging due to the limited options. Although there have been a few reports of successful treatment with thalidomide, literature concerning its use in pediatric patients remains scarce. Here, we present the case of GCS in a 4.5-year-old boy having 5-month history of papulonodular lesions accompanied by low-grade fever and joint swelling. While he initially responded to steroid treatment, complete remission was achieved following an 18-week course of thalidomide, with no recurrence during a 9-month follow-up.