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Calcinosis in systemic sclerosis.

Srijana Davuluri1, Christian Lood2, Lorinda Chung3

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Calcinosis cutis, a complication affecting up to 40% of systemic sclerosis (SSc) patients, involves calcium deposition in tissues. Understanding its prevalence, pathogenesis, and effective treatments like surgery is crucial for managing this condition.

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Area of Science:

  • Rheumatology
  • Dermatology
  • Pathophysiology

Background:

  • Calcinosis cutis is a significant complication in systemic sclerosis (SSc).
  • It affects up to 40% of SSc patients, causing considerable morbidity.
  • Associated factors include long disease duration, vascular dysfunction, and osteoporosis.

Purpose of the Study:

  • To present current knowledge on calcinosis cutis in SSc.
  • Focus on prevalence, pathogenesis, diagnostics, and therapeutics.
  • Provide updated information for clinicians and researchers.

Main Methods:

  • Review of observational studies and biochemical research.
  • Analysis of in-vivo models for pathogenetic insights.
  • Evaluation of diagnostic imaging and therapeutic interventions.

Main Results:

  • Prevalence of calcinosis cutis varies geographically and ethnically.
  • Pathogenesis involves inflammation, mechanical stress, hypoxia, and phosphate metabolism dysregulation.
  • Proton pump inhibitor use may increase risk; minocycline and topical sodium thiosulfate show limited benefit.

Conclusions:

  • Calcinosis cutis involves insoluble calcium deposition in skin and subcutaneous tissues.
  • Altered phosphate metabolism (e.g., FGF-23) is implicated.
  • Plain radiography aids diagnosis; surgery is most effective, but medical therapies lack robust evidence.