Severe calcinosis cutis with cutaneous ulceration in juvenile dermatomyositis.

BACKGROUND: Calcinosis cutis is usually seen in long standing and untreated cases of juvenile dermatomyositis. CASE CHARACTERISTICS: 7-year-old girl with severe calcinosis cutis who developed cutaneous ulceration, rash and myopathy. OBSERVATION: Myopathic changes in EMG, muscle edema in MRI, elevated muscle enzymes and Jo-1 positive antibodies. OUTCOME: Treatment with prednisolone and methotrexate resulted in improvement of the lesion. MESSAGE: Calcinosis cutis may be a presenting feature of juvenile dermatomyositis even in the absence of characteristic findings of rash and weakness.