Search

Calcinosis cutis (CC) is characterized by the deposition of calcium salts in the skin and subcutaneous tissues. CC involving the vulva or foreskin (prepuce) is uncommon. We present a 9‐year‐old female with vulvar CC and a 15‐year‐old male with preputial CC. Microscopic review of excisional specimens revealed calcification associated with follicular cysts in the vulvar case and lichen sclerosus in the preputial case, suggesting a dystrophic origin to a subset of cases of genital CC that might otherwise be classified as idiopathic. The clinical implication of these findings is the need for close histopathologic scrutiny and ongoing clinical surveillance of patients with genital CC initially deemed idiopathic. [ABSTRACT FROM AUTHOR]

Background/Objectives: Calcinosis cutis (CC) is a condition that may develop in the course of several autoimmune connective tissue diseases (ACTDs). Among these, the conditions most frequently associated with CC are systemic sclerosis (SSc) and dermatomyositis (DM). Despite both the prevalence and diversity of available treatment options, therapeutic recommendations remain not fully established due to a limited number of studies and lack of unambiguous evidence regarding their effectiveness. Case Presentation: We report two cases of patients with DM and concomitant massive cutaneous calcifications who were treated: in the case of a 71-year-old man with DM and past medical history of primary cutaneous T-cell lymphoma (CTCL) who received intralesional (IL) 25% sodium thiosulfate (STS) with platelet-rich plasma (PRP) injections, and, in the case of a second patient, 24-year-old woman with nephrolithiasis, who received intravenous immunoglobulin (IVIG) infusions at a dose of 2 g/kg in combination with prednisone at a dose of 5 mg/day. Conclusions: The applied treatment led to reduction in pain, size, and number of calcified lesions. Additionally, healing of fingertip ulcers after PRP injections was observed. While this report highlights only two isolated cases, the use of IVIG and STS with PRP injections appears to be an effective treatment method. Nevertheless, both standardization and additional research are required. [ABSTRACT FROM AUTHOR]

Background: Idiopathic scrotal calcinosis (ISC) is a manifestation of idiopathic calcinosis cutis, and its etiology is still unknown. Case presentation: We report a 36-year-old patient manifested multiple gradually increasing yellowish-white scrotal nodules with occasional itching and stinging in the past 6 years and was successfully cured via surgical excision. The laboratory test combined with pathological analysis confirmed the diagnosis of ISC. Like pathological calcinosis in other soft tissues, a large amount of collagen fiber deposition was observed around the calcification nodule, suggesting that abnormal collagen fiber deposition might be an important factor leading to idiopathic calcinosis in the scrotum. Moreover, koilocytes, which indicate human papillomavirus (HPV) infection, were also detected around calcified nodules, indicating the potential pathogenic role of HPV infection in ISC. Conclusions: Here, we report that ISC shows abnormal excessive deposition of collagen fibers around calcified nodules, which may be a vital factor contributing to the disease. Furthermore, combined with the literature review, a new pathogenic mechanism of ISC is proposed, and the site specificity of scrotal calcinosis is explained, providing a basis for further exploration of the pathogenic mechanism of ISC. [ABSTRACT FROM AUTHOR]

Calcinosis cutis is a condition that is commonly associated with autoimmune connective tissue diseases. It is characterized by the deposition of insoluble calcium salts in the skin and subcutaneous tissue, which can cause pain, impair function, and have significant impacts on quality of life. Calcinosis cutis is difficult to manage because there is no generally accepted treatment: evidence supporting treatments is mostly comprised of case reports and case series, sometimes yielding mixed findings. Both pharmacologic and procedural interventions have been proposed to improve calcinosis cutis, and each may be suited to different clinical scenarios. This review summarizes current treatment options for calcinosis cutis, with discussion of recommendations based on patient-specific factors and disease severity. [ABSTRACT FROM AUTHOR]

Canine leptospirosis is a multisystemic disease that can affect dogs of all ages and lifestyles. This report describes a 4-month-old dog diagnosed with acute leptospirosis and treated with dialysis and antibiotic therapy as well as intensive supportive care for 11 days of hospitalisation. About 10 days after discharge, the dog developed cutaneous lesions that were consistent with calcinosis cutis on histopathology. The lesions resolved within 1 month without specific intervention. This report discusses a potential association between calcinosis cutis and leptospirosis infection and highlights a need for early vaccination to protect young dogs. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Dermatovenereology is the property of Xi'an Jiaotong University Periodicals Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Dermatomyositis is an uncommon inflammatory disease that causes muscle weakness and a distinctive dermatological rash. The objective of this study is to record all clinical presentations in patients with dermatomyositis but mainly dermatological manifestations. Methods This case series descriptive study included 23 patients with dermatomyositis who were seen during the period from 2014-2023. A full history and clinical examination were carried out. All patients were referred from the Rheumatology and Pediatric Units after doing a full assessment and necessary investigations. Results The juvenile group peak consisted of 13 patients, their ages ranged from 3-15 years with a mean of 5 years, 6 males and 7 females. The main clinical picture was photosensitivity with distinctive heliotrope facial rash in all patients, and calcinosis cutis in 8 (61.53%) cases The adult group included 10 subjects, their ages ranged from 30-60 years with a mean of 47 years, 9 females and one male patient. The presenting picture was skin rash in a form of photosensitivity with characteristic heliotrope of the face and muscle weakness of shoulder and pelvic girdles in all cases. No malignancy was reported. Conclusion There was no significant difference between both genders in children, however, it was more prevalent in adult females. The presenting features in the juvenile group were photosensitivity, a heliotrope rash of the face and calcinosis cutis. While photosensitivity with heliotrope dermatitis of the face and muscle weakness was sever in adults. No malignancy was detected during follow-ups in any patient. [ABSTRACT FROM AUTHOR]

An 11‐year‐old boy presented generalized eruptive syringomas (ESs) associated with multiple milia‐like whitish palmar papules corresponding to dermal calcium deposits. A relationship between calcium deposits distribution to an underlying eccrine duct was noted on pathology. The observation of dermal calcium deposits and its association with generalized ESs may support a possible sweat duct origin of this uncommon and peculiar form of superficial calcinosis cutis. [ABSTRACT FROM AUTHOR]

The article discusses a case of a woman in her 40s with recalcitrant acneiform papules on her face, which were later diagnosed as multiple miliary osteoma cutis (MMOC). MMOC is a rare condition characterized by intradermal bone formation, predominantly affecting women in their fourth to fifth decades of life. Diagnosis is confirmed through histopathology, and treatment options include needle extirpation and topical tretinoin. The article emphasizes the importance of considering MMOC in women with resistant acne lesions and suggests biopsy as a diagnostic tool. [Extracted from the article]

The article discusses a rare case of benign osseous metaplasia of the breast in a 63-year-old female with a history of pseudopseudohypoparathyroidism. The patient underwent a tomosynthesis-guided vacuum-assisted biopsy, which revealed benign osseous metaplasia without an associated lesion. The study highlights the importance of providing a thorough clinical history to reduce the risk of radiology-pathology discordance in similar cases. [Extracted from the article]

Abnormal calcium deposition is among the many sequelae that may arise following major burn injury. This may take the form of heterotopic ossification (HO) or calcinosis cutis (CC) within scarred skin. These two processes are distinct, but clinicians sometimes use the term “heterotopic ossification” as a catch-all term to reference any abnormal calcium deposition in a burn survivor. While HO is well-described, less attention has been devoted to CC. We present a case of CC to highlight the distinct presentations of CC vs. HO in hopes of promoting the use of semantically correct terms within the burn care community.

Subepidermal calcified nodules are an uncommon subtype of idiopathic calcinosis cutis. Morphologically, this entity typically present as a single, well-circumscribed, white-yellow nodule. Based on clinical appearance alone, subepidermal calcified nodules are frequently misdiagnosed and often requires histological confirmation. We describe two cases of subepidermal calcified nodules presenting atypically as cutaneous horns. Subepidermal calcified nodules presenting as a cutaneous horn has rarely been reported; on review, there are fewer than 10 such cases have been described within the past 30 years. The cases described here illustrate the clinical variety and should increase awareness of subepidermal calcified nodules presented.

Background/Objectives: Calcinosis cutis is the deposition of insoluble calcium salts, which may cause inflammation, ulceration, pain, and restricted joint mobility. It rarely develops in damaged tissues (dystrophic subtype), most frequently in autoimmune connective tissue diseases (CTDs), but there is very limited data on the prevalence. Also, therapy remains an unsolved issue. In this study, we aimed to collect data on the prevalence of calcinosis in CTD patients to highlight that it is a considerable problem. Methods: A retrospective study was conducted in our department to assess the epidemiology of dystrophic calcinosis in CTDs between January 2003 and January 2024. Results: A total of 839 CTD patients were identified, of whom 56 had calcinosis (6.67%). The mean age of the calcinosis patients at diagnosis of underlying CTD was 41.16 ± 19.47 years. The mean time interval from the onset of calcinosis was 5.96 ± 8.62 years. Systemic sclerosis was the most common CTD complicated by calcinosis (n = 22). Conclusions: Our results are comparable to those reported previously in the literature. Although calcinosis is rare in the overall population, it is a present and unsolved problem in CTD patients. Therefore, further studies are needed on the factors involved in the development and progression of calcinosis as well as its treatment. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course Background: Calcium gluconate is used to treat neonatal hypocalcemia, severe hyperkalemia, and neonatal convulsions. Calcium gluconate can extravasate into the skin's soft tissues, resulting in redness, skin nodules, and calcification of soft tissue, which can cause tissue necrosis. This report presents 2 cases of neonatal calcinosis cutis following the treatment of hypocalcemia with calcium gluconate. Case Reports: Case 1. The patient was a 12-day-old male neonate who presented with a mass in the right foot. He was recently discharged from the hospital after evacuation of subdual hematoma triggering his seizures. The swelling was associated with erythema but no discharge. His radiograph showed soft tissue calcification. He had received 2 peripheral intravenous calcium gluconate infusions to manage hypocalcemia during the last hospitalization. Symptomatic treatments were provided, and full resolution of the swelling was reported after 3 weeks. Case 2. The patient was a 1-month-old female infant newly diagnosed with cystic fibrosis who presented with a mass in her left foot. She underwent exploratory laparotomy in another hospital to manage meconium ileus. The mass was not mobile but there was no skin ulceration. Her radiograph showed soft tissue calcification. During her last admission, she had received 3 doses of intravenous calcium gluconate to manage hypocalcemia. The patient was observed and managed symptomatically. After 4 weeks, there was almost complete clinical and radiographic disappearance of the swelling without any skin necrosis. Conclusions: This report has highlighted the importance of monitoring neonates treated with calcium gluconate who may develop skin rashes or nodules due to calcinosis cutis. [ABSTRACT FROM AUTHOR]

Background: Diascopy is a point‐of‐care diagnostic test used to differentiate skin erythema due to vascular dilation from haemorrhage. In the veterinary literature, only a handful of diseases have been described to be associated with a negative (nonblanching) diascopy result, and histological investigation of haemorrhage has been inconsistent. Objectives: Retrospective study to undertake a histopathological investigation of canine, nonblanching erythematous dermatoses for the presence or absence of haemorrhage and vascular changes. Materials and Methods: Skin biopsies from dogs presented with moderate‐to‐severe nonblanching erythema were evaluated histologically. Additionally, clinical data about each patient were analysed. Results: Twenty cases were identified with nonblanching erythema. Diagnoses included vasculopathy (n = 6), canine eosinophilic dermatitis (n = 3), cutaneous epitheliotropic T‐cell lymphoma (n = 2), and one case each of sterile granuloma and pyogranuloma syndrome, German shepherd dog pyoderma, multiple mast cell tumours, haemangiosarcoma, exfoliative cutaneous lupus erythematosus, canine leishmaniosis with sebaceous adenitis, sebaceous adenitis with concurrent dermatophytosis, calcinosis cutis and canine atopic dermatitis with insect‐bite reaction. One or more vascular changes were present in all 20 cases and included perivascular oedema, endothelial swelling and neutrophilic infiltration of vessel walls. Haemorrhage was identified in 17 of 20 cases (85%). Three cases without dermal haemorrhage were calcinosis cutis, sebaceous adenitis with dermatophytosis and canine atopic dermatitis with insect‐bite reaction. Conclusions and Clinical Relevance: Negative diascopy was associated with haemorrhage and vascular pathological findings in the majority of cases, yet not all. Haemorrhage was identified histologically in all diseases previously reported as nonblanching as well as in a few additional diseases. [ABSTRACT FROM AUTHOR]

This article discusses the use of subcutaneous immunoglobulin (SCIG) as a potential treatment for calcinosis associated with juvenile dermatomyositis (JDM). Calcinosis is a complication of JDM characterized by the abnormal deposition of calcium salts in tissues. The article presents two cases of patients with refractory JDM-associated calcinosis who showed significant improvement with SCIG treatment. SCIG has been shown to have local immunomodulatory effects and may prevent complications such as skin ulceration and infection. Further research is needed to develop evidence-based treatment guidelines for calcinosis. [Extracted from the article]

Background: Pamidronate is used for the treatment of hypercalcemia. However, a rare but potential adverse event of pamidronate treatment is hypocalcemia. This report describes an unusual case of severe, irreversible hypocalcemia after a single injection of pamidronate for the treatment of hypercalcemia due to glucocorticoid withdrawal in a dog. Case presentation: An 11-year-old castrated male Maltese dog presented with anorexia, vomiting, and diarrhea (day 0). The patient had calcinosis cutis throughout the body, calcification of intraabdominal organs, mild azotemia, and severe hypercalcemia. The severe calcification was attributed to long-term glucocorticoid administration, which was discontinued 1 month before presentation. Fluid therapy, diuretics, calcitonin, and a single intravenous injection of pamidronate were used for the treatment of hypercalcemia. On day 14, normocalcemia was achieved, but renal failure occurred. On day 20, severe and irreversible hypocalcemia occurred, and on day 42, the patient was euthanized at the owner's request because of worsened hypocalcemia and renal failure. Conclusions: Although hypocalcemia is an extremely rare adverse event of bisphosphonate treatment, bisphosphonates like pamidronate can result in potentially life-threatening conditions according to the patient's underlying conditions. Therefore, the patient's condition should be closely monitored and any underlying conditions should be carefully evaluated before initiating the treatment for hypercalcemia using pamidronate. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses a case of traumatic dystrophic calcinosis cutis in a 13-year-old girl, successfully treated with topical sodium metabisulfite ointment. Calcinosis cutis involves abnormal calcium deposition in the skin, with dystrophic calcification being the most common type in children. Treatment options for calcinosis cutis include steroids, calcium channel blockers, and surgical excision, with sodium metabisulfite showing promising results in some cases. The study highlights the potential of topical sodium metabisulfite in managing calcinosis cutis, especially in cases resistant to other treatments. [Extracted from the article]

This article presents a case study of a 61-year-old woman who developed painful papules on her lower back 30 years after receiving radiotherapy for sacral Ewing sarcoma. The papules were found to be calcium deposits, a condition known as radiotherapy-induced calcinosis cutis. The patient experienced chronic pain and other complications as a result of the radiotherapy. The article highlights the rarity of this complication and suggests that improvements in radiotherapy techniques may help reduce its occurrence in the future. Treatment options for calcinosis cutis are limited and focus on providing symptomatic relief. [Extracted from the article]

A 53-year-old man with severe psoriasis presented with painful subcutaneous masses on both legs. He had a history of pulmonary embolism and bilateral incompetence of veins. The patient was on medication for psoriasis and had received multiple biologic agents. Radiographic and ultrasound examinations revealed subcutaneous calcification and ossification. The diagnosis was secondary cutaneous ossification in the context of chronic venous insufficiency. Treatment involved managing the underlying venous insufficiency and conservative measures, resulting in a significant reduction in pain. [Extracted from the article]

This article discusses a case series of acquired dermal macular hyperpigmentation (ADMH) in women from North India who wore traditional bangles called "chooras." Ten women presented with asymptomatic hyperpigmentation on their forearms after wearing these bangles made of lac and dyed with red color. The hyperpigmentation was hypothesized to be a hypersensitivity reaction to an unknown component of the bangles. Treatment with topical tacrolimus and sunscreen resulted in significant improvement in hyperpigmentation. The article highlights the cultural practices that can lead to specific dermatoses in different populations. [Extracted from the article]

A young female presented with oligoarthritis of the right hand, painful symmetrical quadriparesis, and darkening skin for 7 months. General physical examination showed hyperpigmentation on the face, neck, upper extremities, calcinosis cutis with swelling and tenderness in the right wrist, and interphalangeal joints with restriction of movements. Neurological examination revealed power in both upper limbs of 3/5 and 4/5 in both lower limbs, all deep tendon reflexes were diminished, and bilateral plantar was flexors. Investigations revealed creatinine phosphokinase - 3991 U/L, lactate dehydrogenase - 1009 mg/dL, antinuclear antibodies by enzyme-linked immunosorbent assay showed anticentromere antibodies positive, and anti-Mi2 positive. Electromyography was suggestive of myopathy. A muscle biopsy confirmed the diagnosis of dermatomyositis (DM). Hence, the diagnosis of limited scleroderma DM overlap syndrome was made. Serial electrocardiography showed sinus bradycardia and ventricular premature ectopics followed by sinus rhythm. She was treated with pulse therapy steroids, hydroxychloroquine, sulfasalazine, antiplatelets, and isoprenaline for cardiac involvement, with improvement in her symptoms. [ABSTRACT FROM AUTHOR]

Calcinosis cutis is a group of disorders characterized by the deposition of calcium salts in the skin and subcutis. It is divided into four different forms based on the etiology: dystrophic, metastatic, idiopathic, and iatrogenic. Idiopathic calcinosis cutis is diagnosed when the other three types have been excluded. We report a case of a 68-year-old female who developed a gradually progressive, hard, nodular swelling in the right iliac region. Clinically it was provisionally diagnosed as a neoplastic lesion. Ultrasound revealed a hyperechoic lesion in the subcutaneous plane, suggestive of a calcified lesion. Fine needle aspiration cytology revealed paucicellular smears, showing aggregates of scattered crystalloid amorphous material favoring the possibility of calcinosis cutis, later confirmed on histopathology. Calcific deposits may clinically mimic a tumor. However, cytology can provide a preliminary diagnosis thus assisting the clinician in the accurate management of these patients. [ABSTRACT FROM AUTHOR]

This article discusses a rare case of fatal pulmonary arterial hypertension (PAH) in an 11-year-old boy with juvenile dermatomyositis (JDM) and anti-MDA5 antibodies. JDM is an autoimmune disorder characterized by skin and muscle inflammation, and anti-MDA5 DM is a subtype associated with a poor prognosis due to a high prevalence of rapidly progressive interstitial lung disease (RP-ILD). PAH is exceptionally rare in JDM, especially in children. The patient presented with muscle weakness, skin rash, and respiratory symptoms, and was diagnosed with JDM with mild ILD and severe PAH. Treatment was initiated, but the patient ultimately succumbed to progressive cardiopulmonary deterioration. The article highlights the potential life-threatening complications of anti-MDA5-associated JDM, including PAH. [Extracted from the article]

This article discusses a case of metastatic calcinosis in a 25-year-old female patient with end-stage kidney disease. Metastatic calcinosis is a rare condition characterized by soft tissue calcification, typically occurring in patients with advanced chronic kidney disease. The patient presented with symptoms such as lower limb edema, arterial hypertension, and nephrotic proteinuria. The diagnosis was confirmed through radiographic evaluation, and phosphate-binding therapy was optimized to improve serum levels. The patient ultimately underwent renal transplantation, resulting in the resolution of symptoms and the reabsorption of calcifications. This case highlights the importance of adequately controlling mineral and bone disorders associated with chronic kidney disease and the benefits of kidney transplantation in reversing complications. [Extracted from the article]

(1) Background: Calcinosis of the skin mainly appears in connective tissue disorders (dystrophic subtype). It may cause inflammation, ulceration, pain, and restricted joint mobility. Management is difficult; sodium thiosulfate is one potential therapeutic agent with promising data on intralesional and topical formulation for smaller calcified lesions. There are very limited data on systemic administration. (2) Methods: A retrospective study was conducted at our department to assess the efficacy of oral and intravenous sodium thiosulfate in dystrophic calcinosis between 2003 and 2023. (3) Results: Seven patients were identified, who received systemic sodium thiosulfate (intravenous or oral). The mean duration of calcinosis at the time of administration was 3.8 ± 4 years (range 0–11). Intravenous sodium thiosulfate was administered in doses of 12.5–25 g two or three times during one week of the month for 4.5 ± 3.9 months on average. Orally, 1–8 g was administered daily for 29.1 ± 40.9 months on average. Four of seven patients had a partial response (57.1%). Despite no complete response, pain, ulceration and inflammation frequency decreased, and sodium thiosulfate prevented further progression in responsive patients. (4) Conclusions: Based on our experience and literature data, systemic sodium thiosulfate may be a potential adjunct therapy in calcinosis, especially if inflamed or ulcerating. [ABSTRACT FROM AUTHOR]

Introduction Systemic Sclerosis (SSc) is an autoimmune connective tissue disease characterized by progressive fibrosis of the skin and internal organs, calcification, and vasculopathy. Anti-MDA5 antibodies are rather uncommon in SSc while being often associated with idiopathic inflammatory myopathy (IIM) with calcinosis cutis. Purpose The study aims to present the first ever reported case of a patient suffering from calcinosis cutis in the course of SSc/IIM overlapping syndrome with clinically relevant anti-MDA5 titers. Material and methods The study reports a 57-year-old post-COVID-19 female patient with massive cutaneous ulcerations of lower extremities that appeared 8 months before admission. Serology revealed high titers of anti-Ro52, anti-MDA5, and anti-Th/To, while other typical SSc antibodies were not found. We discuss the clinical impact of various autoantibodies with an emphasis on anti-MDA-5 including its probable association with SARS-CoV-2. Other autoimmune disorders with calcinosis cutis and its current therapeutic approaches were reviewed. Results The patient's follow-up examination after three months showed significant regression of ulcerations and calcifications, with no new skin lesions being noted. An increased frequency of upper respiratory tract infections was the only adverse effect of the introduced treatment. Conclusions Until now there are no specific therapeutic approaches for the calcinosis cutis in anti-MDA5 positive overlapping SSc/IIM syndrome. We believe this study can help attract clinicians to run further prospective studies concerning the use of cyclosporine in calcinosis cutis in the course of SSc/IIM overlapping syndrome. [ABSTRACT FROM AUTHOR]

Iatrogenic calcinosis cutis represents a subset of calcinosis cutis resulting secondary to treatments or procedures. We present the first report of calcinosis cutis resulting from the intraosseous infusion and one of a few cases with associated transepidermal elimination. A previously healthy 2-year-old female presented with a new-onset unilateral shin rash 1 week following hospitalization for a near-drowning event. A dermatologic exam revealed multiple small, tender, firm, chalky-white papules with surrounding erythema, in addition to two erythematous macules superior and medial to the papular lesions, corresponding to prior intraosseous access sites. The rash persisted despite trials of topical mupirocin and acyclovir cream, prompting a referral to a dermatologist. An excisional biopsy was performed, revealing circumscribed dermal deposits of acellular basophilic material connected to the overlying epidermis through an invaginated keratin plug. A von Kossa silver stain highlighted the deposits, confirming the diagnosis of perforating calcinosis cutis. The lesions did not recur following the excisional biopsy. Iatrogenic calcinosis cutis may be seen as a complication of the infusion of calcium-containing fluids via intraosseous access, in addition to the more commonly observed peripheral intravenous access. Awareness of this disorder is important in order to distinguish it from an infectious mimic and guide the selection of therapy. [ABSTRACT FROM AUTHOR]

Case report: we report the case of a 48-year-old woman with pain in the maxillary sinuses and temporal areas. The presence of subcutaneous facial calcific plaques was confirmed in computed tomography (CT). Both the physical examination and the lab test results were within normal limits. Upon further questioning, the patient mentioned that she had been administered a facial filler product containing calcium hydroxyapatite (CaHA) (Radiesse®) the year before. Discussion: CaHA microspheres are radiopaque, making them visible through conventional x-rays, especially CT scans. The characteristic imaging features, typically bilateral and separate from the bone, along with the history of previous injection of this material, should help the clinician recognize this finding and isolate it from other conditions and diseases. Because of the popularity of this facial rejuvenation technique, clinicians should be familiar with the imaging characteristics associated with the deposition of this substance. [ABSTRACT FROM AUTHOR]

Objective To record and evaluate the different cutaneous manifestations of all patients with an established diagnosis of systemic sclerosis and to have a new therapeutic trial. Methods This is a cross-sectional descriptive clinical study with a therapeutic trial that was conducted during the period from 2014 to 2023. All patients with a well-established diagnosis of systemic sclerosis were evaluated for various skin manifestations. A triple therapeutic trial was carried out using oral zinc sulfate, sildenafil, and prednisolone. Results The main early presenting symptoms were the sensation of coldness usually cold hands and feet seen in 25 (100%) cases, followed by dusky blue red hands and feet observed in 23(92%) cases, followed by difficult hands movement and stiffness together with loss of facial expression in 21 (84%) of patients. Later on, patients mentioned hardening of the face and hands skin with the enhanced shininess of the face. Also pitting scarring of pulps and tips of fingers and sometimes toes could be considered as early symptoms of the disease, seen in 25 (100%) of patients. While the most striking findings on examination were shiny hardening of skin which was most prominent on the face and hands. Difficulty in opening the mouth and protruding the tongue was also a common finding that was detected in 19 (76%) cases. Angiomatous macules and papules of the face were rarely seen as observed only in 3 (12%) female patients. Pitting the pulps and tips of fingers were very early striking findings and very helpful diagnostic signs for diagnosis. Calcinosis cutis commonly affecting elbows were observed as late findings that commonly associated with necrosis of tissue and infections and only observed in 2 (8%) cases. Conclusion Systemic sclerosis usually manifests in cold weather and patients complain of coldness especially on hands and feet with hardening of the skin. Pitting and scarring of the tips of fingers are significant diagnostic findings that are often followed by ischemic changes. While facial angiomatous macules and papules, calcinosis cutis, and rippling pigmentation with leukoderma were detected lately. Triple therapy showed its effectiveness in improving the complaints of patients. [ABSTRACT FROM AUTHOR]

Dystrophic calcinosis cutis (CC) is rarely observed in systemic lupus erythematosus (SLE). To present a case of SLE with a rare cutaneous complication of generalised form of dystrophic CC, most prominent in right infragluteal region, which led to abscess formation. Case presentation A 36-years old female with SLE was admitted to the Institute of rheumatology in Belgrade due to worsening of her condition and post-coronavirus disease 2019 (COVID-19) neck vein thrombosis. She was febrile (up to 38.5 °C) and had fatigue, extensive erythema, livedo reticularis and palpable "orange-peel" skin indurations extending symmetrically to infragluteal, suprapatellar, suprapubic and calf regions. Right infragluteal region had skin inflammation signs with fluctuating central lesion. Her laboratory findings were significant for markedly elevated acute phase reactants. Skin ultrasound showed signs of panniculitis with hypodermal hyperechogenicity and posterior acoustic attenuation. Radiography findings were significant for extensive calcifications in the buttock and knee soft tissue areas and it was confirmed on histopathology of the biopsy. She was started with triple antibiotics (cephtriaxone, ciprofloxacin and metronidazole), high corticosteroids, low molecular weight heparin (LMWH) and the abscess was incised. After resolution of skin infection her immunosuppressive therapy was modified considering her SLE condition, vein thrombosis and calcinosis cutis. Calcinosis cutis is a serious skin complication of SLE as it could predispose to infection. Various pharmacological therapeutic approaches are applied with modest success. [ABSTRACT FROM AUTHOR]

The article discusses a case of a 76-year-old male with hypoparathyroidism presenting symptoms resembling Forestier Disease, including dysphagia, cognitive decline, and muscle cramps. The patient had calcinosis cutis, ossification of ligaments, and basal ganglia calcifications. Treatment with calcium and active vitamin D improved most symptoms, but persistent dysphagia required percutaneous endoscopic gastrostomy. The article highlights the importance of considering extraskeletal calcification-induced dysphagia in hypoparathyroidism cases. [Extracted from the article]

The article "Scleroderma Renal Crisis: Clues From the Physical Exam" published in the Journal of Rheumatology discusses a case of a 56-year-old female presenting with acute encephalopathy and high blood pressure, leading to a diagnosis of scleroderma renal crisis (SRC). The patient showed physical signs such as foreshortened fingers and salt-and-pepper skin changes, along with laboratory findings of renal failure and thrombocytopenia. Treatment with losartan improved her condition, and further evaluation revealed positive Scl-70 antibodies and nonspecific interstitial pneumonia. The article emphasizes the importance of recognizing unique physical exam findings to promptly diagnose and treat SRC in patients with systemic sclerosis. [Extracted from the article]

The Journal of Rheumatology has introduced a new section called "Rheumatology Around the World" to highlight research from low-income countries and underrepresented populations. This initiative aims to publish studies that may not meet traditional publication criteria but are methodologically sound and of high quality. Additionally, the journal has reduced or waived publication fees for these articles and is accepting submissions for this new section. The journal also features Expert Reviews written by experts in the field, covering topics such as physical activity in osteoarthritis and statistical considerations for rheumatologists. [Extracted from the article]

Milia-like idiopathic calcinosis cutis (MICC) and subepidermal calcified nodule (SCN) are described as different entities under the heading of idiopathic calcinosis cutis. Although there are some clinical differences, they share many features. Whereas MICC lesions are located mostly on the extremities and rarely on the face, SCN manifests itself mostly on the face, rarely on the extremities. Milia-like idiopathic calcinosis cutis almost always presents with multiple lesions, whereas SCN shows mainly solitary and rarely multiple lesions. Association with Down syndrome (DS) has been reported in up to two-third of the cases with MICC, but not in SCN. We herein present a 5-months-old girl without DS, manifesting a 2mm solitary, white hard papule surrounded by erythema, located on the finger. Histopathologic findings revealed the presence of dermal calcium deposits. When a solitary papular lesion of idiopathic calcinosis is seen in a child, especially if not associated with DS, it is difficult to differentiate MICC from SCN. We believe that these entities may represent variants of the same pathology and it may be more appropriate to designate a solitary lesion as SCN, regardless of its location.

Cutaneous dystrophic calcification as a late change of radiation therapy is a rarely reported finding. Initially, it was almost exclusively described as occurring on the chest wall in breast cancer patients but has since been described in several other malignancies. We describe the first reported case of radiotherapy-induced calcinosis cutis occurring at the site of a previous liposarcoma. Review of the literature including risk factors, similar cases, pathophysiology, and management is also explored.

Calcinosis cutis is represented by the deposition of insoluble calcium salts in the skin and subcutaneous tissue. Calcinosis can lead to repeated episodes of local inflammation and repeated infections, resulting in pain and functional disability, and even death. Here, we present a case of a patient with SSc who experienced calcinosis universalis and eventually died from recurrent infections at the sacrococcygeal calcification. [ABSTRACT FROM AUTHOR]

A healthy 2‐year‐old girl presented with multiple asymptomatic subcutaneous nodules on both legs. Histologically demonstrated calcium deposition within the dermis and subcutaneous tissue consistent with calcinosis cutis. Laboratory abnormalities, underlying genetic conditions, and potential triggering factors were ruled out. The lesions resolved over an 18‐month period without treatment, emphasizing the importance of the wait‐and‐see approach in idiopathic cases of calcinosis cutis. [ABSTRACT FROM AUTHOR]

Commonly associated with autoimmune and renal disorders, calcinosis cutis is a disorder of systemic calcium deposition in soft tissues. The pathophysiology of such deposition varies based on subtype, therefore treatment options vary not only in terms of severity of disease but also with subtype. This case report describes a 52-year-old female with systemic sclerosis and an extensive past medical history who initially presented with complaints of worsening left lower leg pain, a negative workup for deep vein thrombosis, and an extensive palpable mass in the posterior thigh with erythema, drainage, and purulence. With multiple treatment options exhausted from her autoimmune disorders, she ultimately required surgical resection for her refractory infected calcinosis cutis. Identification of calcinosis cutis subtype in conjunction with appropriate history and physical is crucial to determining indications for treatment. [ABSTRACT FROM AUTHOR]

Subepidermal Calcified Nodule of Ear is an uncommon lesion which is a type of Idiopathic Calcinosis Cutis. It is characterised by calcium deposits in an otherwise normal tissue with no underlying defects in Calcium or phosphorus homeostasis. With an unknown etiopathogenesis, it is usually seen in the paediatric age group. Final diagnosis need a clinicopathological correlation and it underlines the importance of post operative lab investigations which the patient must undergo to rule out any other underlying pathology. We present case of an 8 year old girl with subepidermal calcified nodule of left ear auricle which is a rare occurrence. [ABSTRACT FROM AUTHOR]

Background: Juvenile dermatomyositis (JDM) is the most common autoimmune myositis in children. However, there is a paucity of data on the clinical characteristics of JDM patients in Thailand. Objective: To describe the clinical manifestations, investigations, treatments, complications, and outcomes of JDM in Thailand. Materials and Methods: A bidirectional descriptive study based on past medical records review. All children younger than15 years diagnosed with JDM by Bohan and Peter criteria at King Chulalongkorn Memorial Hospital between January 2010 and December 2022 were enrolled. Results: Thirteen cases were identified with 69% female. The median age at diagnosis and median time to diagnosis were 3.4 (IQR 2 to 6.5) years and 3.5 (IQR 1.2 to 8) months, respectively. The common clinical presentations at disease onset were weakness at 100%, Gottron papules at 69%, and heliotrope rash at 46%. Lactate dehydrogenase was elevated in all cases at diagnosis. Evidence of muscle inflammation was found in 78% of biopsies, 80% of EMGs, and 100% of MRIs. The most common myositis specific Ab was anti-NXP2 at 64%. Most patients had polyphasic disease courses. More than half of the patients, or 62%, developed calcinosis. Six of thirteen cases received recommended treatment with prednisolone and methotrexate at diagnosis. One patient with calcinosis had a good response with infliximab. Conclusion: The present review underscores that JDM patients with younger age at diagnosis will need to be monitored closely and need aggressive long-term treatment. Prompt treatment should be managed according to the severity of symptoms to improve clinical outcomes and prevent serious complications. [ABSTRACT FROM AUTHOR]