---

DERMATOMYOSITIS: Calcinosis

---

Calcinosis   Clinical & Lab   Differential diagnosis     Dermatomyositis (DM-VP)     CREST     Hyperparathyroidism     Paraneoplastic hypercalcemia   Pathology

Axillary calcifications

---

Calcinosis

• Definition: Dystrophic calcification in subcutaneous, myofascial or muscle tissues
• Demography, More common: South America; African-American; Male
• Clinical
  • JDM (DM-VP) Frequency: 12% to 70%; Mean 33%
  • Onset: Several years after disease onset
  • Locations
    • Most common: Elbows, Knees, Other acral regions
    • May be anywhere
    • Trauma sites
    • Subcutaneous
    • Under discolored areas of skin
    • Deep or Superficial
• Risk factors ⁷⁹
  • Clinical
    • Disease
      • Severity: More weakness
      • Earlier onset age (Linear relationship)
      • Skin: Gottron's papules
      • Dermatomyositis > Polymyositis
      • Disease course: Longer duration; Poor response to immunomodulating agents
      • Nailfold capillary Δ ¹
    • Treatment
      • Delayed: Reduced frequency with early corticosteroid treatment
  • Laboratory
    • Autoantibodies
      • NXP-2 (MJ; p140)
        • Frequency: OR 2.1
        • Onset
          • Age: Adults or Children
          • Disease course: Predates calcinosis
        • Calcinosis pattern: Diffuse
      • PM/Scl
    • Serum CK: Lower
    • Genetic associations
      • Pro-inflammatory cytokine polymorphisms
      • Tumor necrosis factor alpha (TNF-α): 308A allele; IL-1a-889C allele
    • Cytokines: Increased local production of TNFα
• Related to: Hydroxyapatite accumulation

---

From Drs. Mina Edelman & Franklin Marden

Subcutaneous calcifications in hand and leg

---

Subcutaneous calcifications (small & fleck-like) in pelvis

---

Return to Neuromuscular Home Page
Return to Inflammatory myopathies
Return to Dermatomyositis

References
1. J Rheumatol 2022 Aug 1

8/2/2022