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Treatment of calcinosis cutis in systemic sclerosis and dermatomyositis: A review of the literature.
- Source :
-
Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2020 Feb; Vol. 82 (2), pp. 317-325. Date of Electronic Publication: 2019 Jul 11. - Publication Year :
- 2020
-
Abstract
- Background: We have limited data on the treatment of calcinosis cutis associated with systemic sclerosis and dermatomyositis.<br />Objective: To assess the efficacy and tolerance of available treatments for calcinosis cutis based on previously published studies.<br />Methods: We performed a systematic review of studies published in Medline, Embase, and the Cochrane library during 1980-July 2018. The strength of clinical data was graded according to the modified Oxford Centre for Evidence-Based Medicine levels of evidence.<br />Results: In all, 30 studies (288 patients) were included. Eleven therapeutic classes, surgery, and physical treatments were identified as potential treatment options for calcinosis cutis. On the basis of results of a small randomized controlled trial and 4 retrospective studies, low-dose warfarin should not be used for calcinosis cutis (level IB evidence). The results of several studies suggest diltiazem and bisphosphonates might be useful treatment options (level IV). Considering biologic therapies, rituximab has shown promising results in treating both dermatomyositis and systemic sclerosis, whereas tumor necrosis factor inhibitors might be useful for treating juvenile dermatomyositis (level IV). Intralesional sodium thiosulfate might be a promising alternative (level IV).<br />Limitations: Few included studies had a high level of evidence.<br />Conclusion: This study highlights the efficacy and tolerance profiles of available treatments for calcinosis cutis, with a focus on level of evidence.<br /> (Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Calcinosis etiology
Dermatologic Surgical Procedures
Dermatomyositis therapy
Diltiazem therapeutic use
Humans
Injections, Intralesional
Physical Therapy Modalities
Randomized Controlled Trials as Topic
Rituximab therapeutic use
Scleroderma, Systemic therapy
Skin Diseases etiology
Thiosulfates administration & dosage
Treatment Outcome
Calcinosis therapy
Dermatomyositis complications
Scleroderma, Systemic complications
Skin Diseases therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6787
- Volume :
- 82
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 31302187
- Full Text :
- https://doi.org/10.1016/j.jaad.2019.07.006