DOI: http://dx.doi.org/10.18203/2349-2902.isj20203279

Calcinosis cutis associated with systemic sclerosis: a rare case report

Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj, Narayanamurthy Sundaramurthy, Anand Prasath Jayachandiran

Abstract


Calcinosis cutis is abnormal calcium deposition in the skin and subcutaneous tissues of the body. It is generally associated with autoimmune connective tissue disorders and in our case, it is systemic sclerosis. It most commonly occurs in the fingers presenting with pain and functional impairment. Here, we present a case of calcinosis cutis with systemic sclerosis in a teenage girl presented with bilateral gluteal pressure sores and multiple sites of calcium deposition like sacrum, upper limbs, knees and the face. We treated here with reconstructive surgery with Limberg flaps for the pressure ulcers with excision and primary closure of the other sites with calcium deposits. 


Keywords


Calcinosis, Dystrophic, Systemic sclerosis, Surgery

Full Text:

PDF

References


Chander S, Gordon P. Soft tissue and subcutaneous calcification in connective tissue diseases. Curr Opin Rheumatol. 2012;24(2):158-64.

Gutierrez JA, Wetter DA. Calcinosis cutis in autoimmune connective tissue diseases. Dermatol Ther. 2012;25(2):195-206.

Valenzuela A, Baron M. The Canadian Scleroderma Research Group, Herrick A, Proudman S, Stevens W et al. Calcinosis is associated with digital ulcers and osteoporosis in patients with systemic sclerosis: A Scleroderma Clinical Trials Consortium Study. 14th Scleroderma Research Workshop August 1-5, 2015; Cambridge, UK; 2015.

Balin SJ, Wetter DA, Andersen LK, Davis MD. Calcinosis cut is occurring in association with autoimmune connective tissue disease: The Mayo Clinic experience with 78 patients, 1996-2009. Arch Dermatol. 2012;148(4):455-62.

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

Avouac J, Mogavero G, Guerini H, Drape JL, Mathieu A, Kahan A, et al. Predictive factors of hand radiographic lesions in systemic sclerosis: a prospective study. Ann Rheum Dis. 2011;70(4):630-3.

Koutaissoff S, Vanthuyne M, Smith V, Langhe DE, 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.

Johnstone EM, Hutchinson CE, Vail A, Chevance A, Herrick AL. Acro-osteolysis in systemic sclerosis is associated with digital ischaemia and severe calcinosis. Rheumatology (Oxford England). 2012;51(12):2234-8.

Vayssairat M, Hidouche D, Baudot AN, Gaitz JP. Clinical significance of subcutaneous calcinosis in patients with systemic sclerosis: Does diltiazem induce its regression. Ann Rheum Dis. 1998;57(4):252-4.

Steen VD, Ziegler GL, Rodnan GP, Medsger JTA. Clinical and laboratory associations of anticentromere antibody in patients with progressive systemic sclerosis. Arthritis Rheum. 1984;27(2):125-31.

D’Aoust J, Hudson M, Tatibouet S, Wick J, Mahler M, Baron M, et al. Clinical and serologic correlates of anti-PM/Scl antibodies in systemic sclerosis: a multicenter study of 763 patients. Arthritis Rheumatol (Hoboken, NJ). 2014;66(6):1608-15.

Reiter N, Shabrawi EL, Leinweber B. Calcinosis cutis: part I. diagnostic pathway. J Am Acad Dermatol. 2011;65(1):1-12.

Gutierrez AJ, Wetter DA. Calcinosis cutis in autoimmune connective tissue diseases. Dermatol Ther. 2012;25(2):195-206.

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

Reiter N, Shabrawi EL, Leinweber B. Calcinosis cutis: part-II. Treatment options. J Am Acad Dermatol. 2011;65(1):15-22.

Nigwekar SU, Kroshinsky D, Nazraian RM. Calciphylaxis: risk factors, diagnosis, and treatment. Am J Kidney Dis. 2015;66(1):133-46.

Nielsen BJ, Olesen AB. Treatment of skin calcifications with intra-lesional injection of sodium thiosulphate: a case series. Acta Derm Venereol. 2016;96:257-8.

Garcıa GE, Lopez L, Opez R, Vayo ADC. Iatrogenic calcinosis cutis successfully treated with topical sodium thiosulfate. Pediatr Dermatol. 2017;34(3):356-8.

Wolf EK, Smidt AC, Laumann AE. Topical sodium thiosulfate therapy for leg ulcers with dystrophic calcification. Arch Dermatol. 2008;144(12):1560-2.

Bair B, Fivenson D. A novel treatment for ulcerative calcinosis cutis. J Drugs Dermatol. 2011;10(9):1042-4.