Journal List > J Korean Rheum Assoc > v.17(2) > 1003722

Kim, Lee, Lee, Harn, Munkhdelger, Cho, and Kang: A Case of Diffuse Muscular Calcification following Necrotizing Cutaneous Vasculitis in a Patient with Dermatomyositis

Abstract

Dermatomyositis is a systemic connective tissue disease affecting the skeletal muscles and skin. Necrotizing cutaneous vasculitis and subsequent diffuse subcutaneous and muscular calcification in patients with dermatomyositis is uncommon and has not been reported. A 23-year-old female with dermatomyositis developed necrotizing cutaneous vasculitis in the knee, elbow, buttock, toe and fingers associated with large ulcer formation. Her left 5th finger was amputated due to massive soft tissue destruction, and her right 5th finger later auto- amputated. Thereafter, she developed small subcutaneous nodules on both wrists, elbows, upper arms, neck, buttocks and thighs. X-ray, computerized tomography and gracilis muscle biopsy confirmed diffuse subcutaneous, fascia and muscular calcifications.

REFERENCES

1). Goebels N., Michaelis D., Engelhardt M., Huber S., Bender A., Pongratz D, et al. Differential expression of perforin in muscle-infiltrating T cells in polymyositis and dermatomyositis. J Clin Invest. 1996. 97:2905–10.
crossref
2). Bohan A., Peter JB. Polymyositis and dermatomyositis (second of two parts). N Engl J Med. 1975. 292:403–7.
3). Bohan A., Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975. 292:344–7.
4). Feldman BM., Rider LG., Reed AM., Pachman LM. Juvenile dermatomyositis and other idiopathic inflammatory myopathies of childhood. Lancet. 2008. 371:2201–12.
crossref
5). Blane CE., White SJ., Braunstein EM., Bowyer SL., Sullivan DB. Patterns of calcification in childhood dermatomyositis. AJR Am J Roentgenol. 1984. 142:397–400.
crossref
6). Boulman N., Slobodin G., Rozenbaum M., Rosner I. Calcinosis in rheumatic diseases. Semin Arthritis Rheum. 2005. 34:805–12.
crossref
7). Kim JS., Jung JW., Song HJ., Kim JE., Lee JW., Choi JH, et al. A case of adult dematomyositis with diffuse soft tissue calcification. J Korean Rheum Assoc. 2003. 10:61–5.
8). Carlson JA., Ng BT., Chen KR. Cutaneous vasculitis update: diagnostic criteria, classification, epidemiology, etiology, pathogenesis, evaluation and prognosis. Am J Dermatopathol. 2005. 27:504–28.
crossref
9). Carlson JA., Chen KR. Cutaneous vasculitis update: small vessel neutrophilic vasculitis syndromes. Am J Dermatopathol. 2006. 28:486–506.
crossref
10). Luqmani RA., Pathare S., Kwok-Fai TL. How to diagnose and treat secondary forms of vasculitis. Best Pract Res Clin Rheumatol. 2005. 19:321–36.
crossref
11). Bacon PA., Stevens RJ., Carruthers DM., Young SP., Kitas GD. Accelerated atherogenesis in autoimmune rheumatic diseases. Autoimmun Rev. 2002. 1:338–47.
crossref
12). Mitchell JP., Dennis GJ., Rider LG. Juvenile dermatomyositis presenting with anasarca: A possible indicator of severe disease activity. J Pediatr. 2001. 138:942–5.
crossref
13). Braunstein EM., White SJ. Pneumatosis intestinalis in dermatomyositis. Br J Radiol. 1980. 53:1011–2.
crossref
14). Neves Fde S., Shinjo SK., Carvalho JF., Levy-Neto M., Borges CT. Spontaneous pneumomediastinum and dermatomyositis may be a not so rare association: report of a case and review of the literature. Clin Rheumatol. 2007. 26:105–7.
crossref
15). Bottomley WW., Goodfield MJ., Sheehan-Dare RA. Digital calcification in systemic sclerosis: effective treatment with good tissue preservation using the carbon dioxide laser. Br J Dermatol. 1996. 135:302–4.
crossref
TOOLS
Similar articles