Antonia Valenzuela1, Paula Song2, Lorinda Chung3. 1. Stanford University School of Medicine, Division of Immunology and Rheumatology, Palo Alto, California. 2. Santa Clara Valley Medical Center, Department of Medicine, San Jose, California. 3. Stanford University School of Medicine and Palo Alto VA Healthcare System, Division of Immunology and Rheumatology, and Dermatology, Palo Alto, California, USA.
Abstract
PURPOSE OF REVIEW: To provide an update on the available literature regarding the epidemiology, pathophysiology, diagnosis, and treatment of calcinosis cutis in patients with systemic sclerosis (SSc). RECENT FINDINGS: We identified observational studies that describe the frequency of calcinosis in SSc and associated clinical features; molecular studies exploring potential pathogenic mechanisms; and case reports and case series describing new diagnostic approaches and treatments. SUMMARY: Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. It represents a major clinical problem in patients with SSc affecting at least one quarter of patients. It is associated with longer disease duration, digital ulcers, acro-osteolysis, positive anticentromere antibody, and positive anti-PM/Scl antibody. Although pathogenesis is unknown, there is evidence supporting local trauma, chronic inflammation, vascular hypoxia, and dysregulation of bone matrix proteins as potential mechanisms. Diagnosis can be made clinically or with plain radiography. Several pharmacologic therapies have been tried for calcinosis with variable and modest results, but surgical excision of calcium deposits remains the mainstay of treatment.
PURPOSE OF REVIEW: To provide an update on the available literature regarding the epidemiology, pathophysiology, diagnosis, and treatment of calcinosis cutis in patients with systemic sclerosis (SSc). RECENT FINDINGS: We identified observational studies that describe the frequency of calcinosis in SSc and associated clinical features; molecular studies exploring potential pathogenic mechanisms; and case reports and case series describing new diagnostic approaches and treatments. SUMMARY:Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. It represents a major clinical problem in patients with SSc affecting at least one quarter of patients. It is associated with longer disease duration, digital ulcers, acro-osteolysis, positive anticentromere antibody, and positive anti-PM/Scl antibody. Although pathogenesis is unknown, there is evidence supporting local trauma, chronic inflammation, vascular hypoxia, and dysregulation of bone matrix proteins as potential mechanisms. Diagnosis can be made clinically or with plain radiography. Several pharmacologic therapies have been tried for calcinosis with variable and modest results, but surgical excision of calcium deposits remains the mainstay of treatment.
Authors: Marilia M Sampaio-Barros; Lorena C M Castelo Branco; Liliam Takayama; Marco Antonio G Pontes Filho; Percival D Sampaio-Barros; Rosa Maria R Pereira Journal: Clin Rheumatol Date: 2019-06-19 Impact factor: 2.980
Authors: Carmen Bobeica; Elena-Laura Parapiru; Carmina Liana Musat; Ciprian Dinu; Iulia Chiscop; Luiza Nechita; Mihaela Debita; Victorita Stefanescu; Ioana Anca Stefanopol; Alexandru Nechifor; Ana Maria Pelin; Gabriela Balan; Silvia Chirobocea; Claudiu Ionut Vasile; Elena Niculet; Mihaela Craescu; Alin Laurentiu Tatu Journal: J Inflamm Res Date: 2022-06-09
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