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Calcinosis in systemic sclerosis: subsets, distribution and complications.

Francesca Bartoli1, Ginevra Fiori2, Francesca Braschi2

  • 1Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence, Florence, Italy francesca.bartoli19@gmail.com.

Rheumatology (Oxford, England)
|June 1, 2016
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Summary

A new classification for calcinosis in Systemic Sclerosis (SSc) patients categorizes it as mousse, stone, net, or plate based on clinical and X-ray features. This classification may aid in early treatment and complication prevention.

Keywords:
calcinosissystemic sclerosis

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Area of Science:

  • Rheumatology
  • Dermatology
  • Radiology

Background:

  • Calcinosis is a common complication in Systemic Sclerosis (SSc).
  • Accurate classification of calcinosis is crucial for understanding its impact and guiding treatment.
  • Existing classifications may not fully capture the diverse features of calcinosis in SSc.

Purpose of the Study:

  • To retrospectively analyze the clinical and radiological features of calcinosis in a cohort of Systemic Sclerosis patients.
  • To propose a novel classification system for calcinosis based on observed features.

Main Methods:

  • Retrospective analysis of SSc patient charts from the Ulcer Unit of the Rheumatology Department, University of Florence.
  • Inclusion of patients with clinical suspicion of calcinosis.
  • Data collection included clinical history, examination, radiological imaging, demographics, SSc organ involvement, and pain assessment.

Main Results:

  • 316 calcinoses were identified in 52 out of 112 SSc patients.
  • Calcinoses were classified macroscopically as mousse (31.8%) and stone (68.2%), and by palpation as net (3%) and plate (13.8%), and stone (83.2%).
  • X-ray classification revealed stone (91.4%), net (3.8%), and plate (4.8%) types. Skin ulcers complicated 48.7% of calcinoses. Mousse calcinosis correlated with pulmonary arterial hypertension; stone with pulmonary involvement; net calcinosis showed slower healing.

Conclusions:

  • A new classification system for calcinosis in SSc patients is proposed: mousse, stone, net, and plate, based on clinical and X-ray characteristics.
  • This classification requires further validation for clinical practice.
  • The proposed classification aims to support early treatment and prevention of calcinosis-related complications in SSc.