Therapy-resistant dermatomyositis with extensive 'lumbar belt' calcinosis

BMJ Case Rep. 2022 May 18;15(5):e249110. doi: 10.1136/bcr-2022-249110.

Abstract

Calcinosis cutis (CC) is the umbrella term for calcium salt deposition on skin and subcutaneous tissue. We present a unique case of CC associated with anti-Mi2-positive dermatomyositis, having a distinctive distribution of subcutaneous calcifications appearing as a 'lumbar belt'. Treatment of CC remains challenging for clinicians due to a lack of high-quality evidence. Corticosteroids, methotrexate, bisphosphonates, intravenous immunoglobulin replacement, rituximab and sodium thiosulfate failed to halt calcinosis progression in this case. Newer therapies, such as Janus kinase inhibitors, should be considered.

Keywords: Biological agents; Musculoskeletal syndromes; Radiology; Rheumatology.

Publication types

  • Case Reports

MeSH terms

  • Calcinosis* / diagnostic imaging
  • Calcinosis* / drug therapy
  • Dermatomyositis* / diagnosis
  • Dermatomyositis* / drug therapy
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Rituximab
  • Skin Diseases*

Substances

  • Immunoglobulins, Intravenous
  • Rituximab