DOI: http://dx.doi.org/10.18203/2349-2902.isj20213610

Calcinosis cutis in systemic sclerosis: a conundrum

Youssef W. Mourad, Martine A. Loius

Abstract


Calcinosis cutis (CC) is an autoimmune disorder that presents with a wide range of systemic manifestations. Respiratory and gastrointestinal tracts along with skin are affected. Skin manifestations can progress to significant deformities, causing discomfort to patients severely affecting quality of life. Management of patients with Scleroderma requires a multidisciplinary approach in order to attain the best possible outcomes. Wound care is not yet standardized and multiple approaches exist with varying degrees of success. Surgical approaches vary based on anatomical location along with the depth and area of the wound. It is imperative to provide continuity of care with this patient population. If there is not adequate communication with regards to expectations, the disease burden may progress and ultimately prolong patient treatment. We presented the case of a 65 year old female with scleroderma that is followed within our wound care clinic for long term care of cutaneous lesions. Wound healing varied throughout the duration of treatment with moderate success seen with the use of wound vac therapy.


Keywords


Calcinosis cutis, Scleroderma, Wound care

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References


Valenzuela A, Song P, Chung L. Calcinosis in scleroderma. Curr Opin Rheumatol. 2018;30(6):554-61.

Pai S, Hsu V. Are there risk factors for scleroderma-related calcinosis? Mod Rheumatol. 2018;28(3):518-22.

Niebel D, Poortinga S, Wenzel J. Osteoma cutis and calcinosis cutis: "similar but different". J Clin Aesthet Dermatol. 2020;13(11):28-31.

Rumancik BE, Rahnama-Moghadam S. Severe iatrogenic calcinosis cutis from extravasated calcium gluconate. Cureus. 2020;12(8):9712.

Róbert L, Kiss N, Medvecz M, Kuroli E, Sárdy M, Hidvégi B. Epidemiology and treatment of calcinosis cutis: 13 years of experience. Indian J Dermatol. 2020;65(2):105-11.

Wasserman PL, Wiesler C, Kurra C, Omman R, Taylor K, Puri R. MR imaging findings of calcinosis cutis in primary Sjogren syndrome, a rare manifestation. Radiol Case Rep. 2020;15(7):1029-38.

Chander S, Gordon P. Soft tissue and subcutaneous calcification in connective tissue diseases. Curr Opin Rheumatol. 2012; 24:158-64.

Daoussis D, Antonopoulos I, Liossis SN, Yiannopoulos G, Andonopoulos AP. Treatment of systemic sclerosis-associated calcinosis: a case report of rituximab-induced regression of CREST-related calcinosis and review of the literature. Sem Arthritis Rheum. 2012;41(6):822-9.

Demirsoy EO, Çatal C, Yazıcı A, Bayramgurler D. A rare cause of leg ulcer: calcinosis cutis as a part of CREST syndrome. Int J Low Extrem Wounds. 2018;17(4):282-4.

Chamberlain AJ, Walker NP. Successful palliation and significant remission of cutaneous calcinosis in CREST syndrome with carbon dioxide laser. Dermatol Surg. 2003;29(9):968-70.

Merlino G, Germano S, Carlucci S. Surgical management of digital calcinosis in CREST syndrome. Aesthetic Plast Surg. 2013;37(6):1214-9.

Al-Najjar M, Jackson MJ. Non-healing leg ulcers in a patient with dystrophic calcification and crest syndrome: a challenging clinical case. Int Wound J. 2011;8(5):537-41.

Valenzuela A, Chung L. Calcinosis: pathophysiology and management. Curr Opin Rheumatol. 2015;27(6):542-8.

Koutaissoff S, Vanthuyne M, Smith V, Langhe ED, Depresseux G, Westhovens R, et al. Hand radiological damage in systemic sclerosis: comparison with a control group and clinical and functional correlations. Semin Arthritis Rheum. 2011;40(5):455-60.

Mukamel M, Horev G, Mimouni M. New insight into calcinosis of juvenile dermatomyositis: a study of composition and treatment. J Pediatr. 2001;138(5):763-6.

Shahi V, Wetter DA, Howe BM, et al. Plain radiography is effective for the detection of calcinosis cutis occurring in association with autoimmune connective tissue disease. Br J Dermatol. 2014;170(5):1073-9.

Sawke GK, Rai T, Sawke N. Iatrogenic calcinosis cutis: a rare cytological diagnosis. J Cytol. 2016;33(3):166-8.