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ONLINE Images in the Medical Sciences| Volume 356, ISSUE 4, e35, October 2018

Extensive Calcinosis Cutis inOverlap Syndrome

Published:June 12, 2018DOI:https://doi.org/10.1016/j.amjms.2018.06.004
Extensive Calcinosis Cutis inOverlap Syndrome
Previous ArticleMultimodality Diagnosis of Mirizzi Syndrome
      A 47-year-old Caucasian man presented to the rheumatology clinic to re-establish care after he had been lost to follow-up. He had been previously diagnosed with polymyositis (PM) and diffuse systemic sclerosis (SS) overlap syndrome. Clinical examination revealed extensive hard subcutaneous nodules on the patient's hands, elbows, shoulders, knees, hips, buttocks and back. Plain radiography of the hips showed extensive calcinosis cutis (Figures 1 and 2). Blood tests revealed elevated muscle enzymes and positivity for antinuclear antibody 1:2560 nucleolar pattern and anti-PM-Scl antibodies. Tests for anti-Scleroderma-70 and anti-RNA polymerase III antibodies were negative. Antinuclear matrix protein 2 autoantibodies, which are well described in PM and linked with calcinosis, were negative as well. The patient was started on prednisone and mycophenolate mofetil, which helped normalize the muscle enzymes but did not impact the calcinosis cutis.
      Fig 1
      Figure 1.
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      Figure 2.
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      Article info

      Publication history

      Published online: June 12, 2018
      Accepted: June 5, 2018
      Received: March 28, 2018

      Footnotes

      ☆The author has no financial or other conflicts of interest to disclose.

      Identification

      DOI: https://doi.org/10.1016/j.amjms.2018.06.004

      Copyright

      © 2018 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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