Calcinosis in systemic sclerosis: subsets, distribution and complications

Bartoli, Francesca; Fiori, Ginevra; Braschi, Francesca; Amanzi, Laura; Bruni, Cosimo; Blagojević, Jelena; Bellando-Randone, Silvia; Cometi, Laura; Mueller, Carolina de Souza; Guiducci, Serena; Rasero, Laura; Epifani, Francesco; Fürst, Daniel E.; Matucci‐Cerinic, Marco

doi:10.1093/rheumatology/kew193

Cited by 44 publications

(36 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, calcinosis can occur in other areas, including paravertebral sites, and reach the size of tumoral calcinosis [61]. Calcifications occur in the chronic phase of disease-in SSc, about 9 years after onset and more commonly in limited cutaneous SSc [62]. Anecdotally, the calcification anticipates the diagnosis of SSc [61].…”

Section: Calcinosismentioning

confidence: 99%

Patients with Interstitial Lung Disease Secondary to Autoimmune Diseases: How to Recognize Them?

Sambataro

Pignataro³

et al. 2020

Diagnostics

View full text Add to dashboard Cite

The diagnostic assessment of patients with Interstitial Lung Disease (ILD) can be challenging due to the large number of possible causes. Moreover, the diagnostic approach can be limited by the severity of the disease, which may not allow invasive exams. To overcome this issue, the referral centers for ILD organized Multidisciplinary Teams (MDTs), including physicians and experts in complementary discipline, to discuss the management of doubtful cases of ILD. MDT is currently considered the gold standard for ILD diagnosis, but it is not often simple to organize and, furthermore, rheumatologists are still not always included. In fact, even if rheumatologic conditions represent a common cause of ILD, they are sometimes difficult to recognize, considering the variegated clinical features and their association with all possible radiographic patterns of ILD. The first objective of this review is to describe the clinical, laboratory, and instrumental tests that can drive a diagnosis toward a possible rheumatic disease. The secondary objective is to propose a set of first-line tests to perform in all patients in order to recognize any possible rheumatic conditions underlying ILD.

show abstract

Section: Calcinosismentioning

confidence: 99%

Patients with Interstitial Lung Disease Secondary to Autoimmune Diseases: How to Recognize Them?

Sambataro

Pignataro³

et al. 2020

Diagnostics

View full text Add to dashboard Cite

show abstract

“…Although different systemic or topical treatments have been proposed for the treatment of calcinosis, 23‐27 in our experience the use of a standard protocol of mechanical debridement with a scalpel, aimed at removing the calcium deposits was able to treat all the DUs with SC, although we observed a longer healing time in this group of patients 12 . This longer time may be linked to the difficult removal of the calcium deposit, which is painful for the patients, even if topical anaesthetics are applied.…”

Section: Discussionmentioning

confidence: 65%

“…The presence of SC has been evaluated according to the presence/absence of calcium deposits, evaluation of the type of calcium deposits according to Bartoli et al for the presence of nets, plate, stone, and mousse 12 …”

Section: Methodsmentioning

confidence: 99%

The impact of skin calcinosis on digital ulcers in patients with SSc: clinical and prognostic stratification using the “wound bed score”

Barsotti

Vicennati

Battista

et al. 2020

International Wound Journal

View full text Add to dashboard Cite

Digital ulcers (DUs) represent one of the major burdens for patients with systemic sclerosis (SSc), especially when associated with skin calcinosis (SC). The aim of this work is to evaluate the impact of SC in DUs of patients with SSc for clinical characteristics and prognosis assessed by the wound bed score (WBS). We prospectively enrolled 55 patients with DUs and SSc followed in our dedicated wound care clinic. For all the patients we collected clinical and anthropometric data and characteristics of the DU, and we calculated the WBS for each DU. Ninety‐nine DUs were evaluated (24 with SC). SC was prevalent in limited cutaneous SSc (75%) and in patients with longer disease duration (P = 0.02). SC‐DUs were prevalent at the fingertip (P = 0.04). The healing time was significantly higher in patients with SC (10.4 ± 7.9 weeks) compared with non‐SC (7.0 ± 5.7 weeks) P = 0.03. The WBS negatively correlated with the time to achieve complete healing (r = −0.237 P = 0.023) and the correlation was maintained in the non‐SC (r = −0.46, P = 0.033). DUs in SSc patients with SC are common and difficult to heal. When DUs are treated in dedicated centres, the prognosis is good. The WBS is fast and easy and maybe commonly applied in clinical practice.

show abstract

“…Evidence of ILD on computed tomography, supported by a restrictive pattern on pulmonary function tests, was accepted as interstitial pulmonary disease. 15 Pulmonary hypertension was considered when systolic PAP was estimated to be >40 mmHg by Doppler echocardiogram or when the mean PAP was found to be equal or higher than 25 mmHg at rest in RHC. 16 Heart involvement: the presence of one of the following pathologies: pericarditis, ischemic cardiomyopathy of unknown origin, disturbance on color Doppler echocardiography, electrocardiographic anomaly that cannot be explained by another cause or left ventricular ejection fraction below 50% is considered as cardiac involvement.…”

Section: Methodsmentioning

confidence: 99%

Correlations Between Clinical Features and Mouth Opening in Patients With Systemic Sclerosis

et al. 2020

View full text Add to dashboard Cite

Objectives: This study aims to investigate the correlations between clinical features and mouth opening in patients with systemic sclerosis (SSc). Patients and methods: Eighty patients with SSc (13 males, 67 females; mean age 53.4±11.7 years; range, 31 to 76 years) followed in our clinic were enrolled in the study. Skin involvement was assessed using the modified Rodnan skin score (mRSS), joint/tendon involvement with fingertip to palm (FTP) distance and interstitial lung disease (ILD) was evaluated with clinical and radiologic methods. The interincisal distance (ID) measurement was used to assess the maximal mouth opening capacity. We examined associations between the ID and clinical features of SSc. Results: The ID was lower in females compared with males, and in diffuse type compared with the limited type (p<0.001 and p<0.001, respectively). A significant negative correlation was found between the ID with mRSS and FTP distance (p<0.001 and p=0.001, respectively). The ID was lower in patients with ILD than in patients without ILD (p=0.006). A formula was constituted to predict the maximal mouth opening of the patient with regression analysis. According to the formula, being male was associated with an increase of 6.14 mm, the presence of ILD with a decrease of 3.19 mm, every 10 mm increment in mRSS with a decrease of 3.72 mm and FTP distance >0 mm with a decrease of 5.13 mm in mouth opening. Conclusion: Microstomia is associated with low quality of life in patients with SSc. In our study, sex, ILD, mRSS, and FTP distance were observed to be the most important factors that were related with mouth opening in patients with SSc.

show abstract

Calcinosis in systemic sclerosis: subsets, distribution and complications

Abstract: Our data indicate that calcinosis may be classified in SSc as mousse, stone, net and plate according to its clinical and X-ray features. This classification awaits validation for a possible use in clinical practice and to support early treatment and prevention of complications.

Cited by 44 publications

References 9 publications

Patients with Interstitial Lung Disease Secondary to Autoimmune Diseases: How to Recognize Them?

Patients with Interstitial Lung Disease Secondary to Autoimmune Diseases: How to Recognize Them?

The impact of skin calcinosis on digital ulcers in patients with SSc: clinical and prognostic stratification using the “wound bed score”

Correlations Between Clinical Features and Mouth Opening in Patients With Systemic Sclerosis

Contact Info

Product

Resources

About