Systemic sclerosis

A 74-year-old man presented with clinically significant functional limitation. What is the diagnosis?

Dx: Systemic sclerosis

Explanation : Calcinosis cutis can be a complication of systemic sclerosis, the diagnosis in this case.

Calcification of the skin is a feature of several connective tissue diseases. There is usually no detectable biochemical abnormality.

Widespread cutaneous calcification may be a feature of juvenile dermatomyositis. Usually there is an non-specific illness with tender muscles. Once the diagnosis is made and corticosteroid therapy commenced there may be dramatic calcification. No treatment is proven to be effective but diphosphonates and EDTA have been tried. There may be some improvement in the condition with time, particularly during puberty.

Cutaneous calcification may be a feature of the CREST syndrome and Raynaud’s disease. Calcium is deposited in the fingers and may discharge from the skin.