AB0814 Sodium thiosulfate 10% intralesional to treat calcinosis in patients with systemic sclerosis and dermatomyositis: case series

Tonial, A.F.; Cathcart, M.P.M.; Santos, Thiago Alberto Fernandes Gomes Dos; Azevedo, Pedro Ming; Skare, Thelma Larocca; Martín, Patricia

doi:10.1136/annrheumdis-2018-eular.6030

Cited by 1 publication

(3 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Healing lesions may be prone to infection (9%, emerging mainly from the skin microbiome) due to softened calcifications [10] and injury caused by the injection. Some patients experienced less pain after completed therapy (median VAS scale reduction of 1, range 0-5), despite unsuccessful size reduction of calcifications [21]. Twelve patients reported by Winter et al [22] (with control lesions) and Tonial et al [21] demonstrated no significant change in size after 3-8 IL-STS injections, although low doses and long injection intervals could disadvantage the treatment efficacy in these studies.…”

Section: Stsmentioning

confidence: 81%

“…A total of 410 articles were retrieved from the search. Additionally, ten more studies were added after the manual screening of the reference sections [10,[17][18][19][20][21][22][23][24][25]. Eight articles were excluded at the eligibility stage due to reporting patients described in other included studies [20,26,27] or insufficient data [24,25,[28][29][30].…”

Section: Study Selectionmentioning

confidence: 99%

“…Included articles consisted of one prospective double-blind placebo-controlled pilot study [22], 7 case series [4,5,10,13,17,18,21,[31][32][33][34][35], and 27 case reports [36][37][38][39][40][41][42][43][44]. Five conference abstracts were included [19,21,33,45,46]. In two studies only, a control group was present and defined as another lesion in the same patient [22,34].…”

Section: Quality Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Local, non-systemic, and minimally invasive therapies for calcinosis cutis: a systematic review

2021

View full text Add to dashboard Cite

Calcinosis cutis is a deposition of calcium in the skin and subcutaneous tissue, often accompanied by pain, reduced mobility, and chronic infections. Limited evidence is available about the feasibility and efficacy of therapies alternative to systemic treatment and surgical excision, both of which often lead to unsatisfactory results or complications. We conducted a systematic review to evaluate the efficacy and safety of topical and intralesional sodium thiosulfate, extracorporeal shock-wave lithotripsy (ESWL), and laser for calcinosis cutis. PubMed, Embase, and Web of Science were searched. Reports of calciphylaxis and treatment combined with systemic medications were excluded. A total of 40 studies including 136 patients were analysed. Partial or complete remission after monotherapy was observed in 64% to 81% of cases. Self-applied topical sodium thiosulfate required patient’s adherence (mean treatment duration, 4.9 months; range 2–24). Laser therapy enabled complete remission of microcalcifications after a single procedure (57%; 12/21). ESWL and intralesional sodium thiosulfate injections decreased calcinosis-associated pain (median reduction in VAS score, 3; range 0–9 and 1; range 0–5, respectively). The most common adverse event was scarring and hyperkeratosis, observed after CO2 laser (56%; 10/18). Intralesional sodium thiosulfate injections caused transient pain in over 11% of patients. Recurrences within the follow-up were rare (2%; 3/136). This study provides an overview of minimally invasive and local therapies that in selected cases might transcend conventional treatment. The limitation of this study is the poor level of evidence, which emerges mainly from non-randomized studies at high risk of bias.

show abstract