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Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis
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Dermatomyositis presenting with diffuse calcinosis.

Madalyn Walsh1, Brittany Bettendorf2, Carleigh Zahn3

  • 1Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA madalyn-walsh@uiowa.edu.

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|December 16, 2023
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Summary
This summary is machine-generated.

This case highlights an unusual presentation of dermatomyositis where calcinosis cutis was the primary symptom. It emphasizes considering soft tissue calcification in differential diagnoses, especially with NXP-2 antibodies.

Keywords:
RadiologyRheumatology

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Area of Science:

  • Rheumatology
  • Dermatology
  • Medical Imaging

Background:

  • Dermatomyositis is an idiopathic inflammatory myopathy characterized by muscle weakness and characteristic skin rashes.
  • Calcinosis cutis, the deposition of calcium in the skin and subcutaneous tissues, can occur in dermatomyositis, though often as a secondary finding.

Observation:

  • A woman in her 50s presented with posterior knee nodules, found to have diffuse subcutaneous calcifications on imaging.
  • Further investigations, including myositis panel, EMG, and muscle biopsy, confirmed an inflammatory myopathy.

Findings:

  • The patient was diagnosed with an uncommon form of dermatomyositis where calcinosis cutis was the presenting complaint.
  • This presentation underscores that soft tissue calcification can be a primary manifestation of dermatomyositis.

Implications:

  • A broad differential diagnosis is crucial for patients with soft tissue calcification, even without typical dermatomyositis symptoms.
  • The presence of NXP-2 antibodies warrants consideration for underlying malignancy, necessitating a thorough workup.