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Severe calcinosis cutis with cutaneous ulceration in juvenile dermatomyositis
Bijay Kumar Meher1, Pravakar Mishra, Pradeep Sivaraj
1Department of Paediatrics, Sardar Vallavbhai Patel Post Graduate Institute of Paediatrics, SCB Medical College, Cuttack; and *Department of Rheumatology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India. Correspondence to: Dr Bijay Kumar Meher, 34/B, Vima Bihar, Sector-6, CDA, Cuttack, Odisha, India. bkmeher187@yahoo.co.in.
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.
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