Considerations for Hand Surgery in Patients With Scleroderma

Brown, Carolyn S.; Crouser, Nisha; Speeckaert, Amy

doi:10.1177/15589447211017211

Cited by 2 publications

(1 citation statement)

References 73 publications

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“…Surgical excision of calcinotic lesions is an effective approach, particularly for periarticular lesions in the hands causing nerve compression [87 ▪ ] and/or severe physical discomfort. Spinal canal stenosis causing radiculopathy treated with decompressive laminectomy results in symptom alleviation [18].…”

Section: Managementmentioning

confidence: 99%

Calcinosis in systemic sclerosis

Davuluri

Lood

Chung

2022

Current Opinion in Rheumatology

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Purpose of reviewThe aim of this study was to provide updated information on the prevalence, pathogenesis, diagnostics and therapeutics of calcinosis cutis associated with systemic sclerosis (SSc).Recent findingsObservational studies show ethnic and geographical differences in the prevalence of calcinosis. In addition to clinical and serological associations, biochemical studies and in-vivo models have attempted to explain theories behind its pathogenesis, including prolonged state of inflammation, mechanical stress, hypoxia and dysregulation in bone and phosphate metabolism. Long-term use of proton pump inhibitors may increase the risk for calcinosis in SSc. Few single-centre observational studies have shown mild benefit with minocycline and topical sodium thiosulfate.SummaryCalcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. It affects up to 40% of SSc patients and causes significant morbidity. Long disease duration, features of vascular dysfunction and osteoporosis have been associated with calcinosis. Altered levels of inorganic pyrophosphate and fibroblast growth factor-23 have been implicated in dysregulated phosphate metabolism that may lead to calcinosis in SSc. Plain radiography can help with diagnosis and quantifying the calcinosis burden. Surgical treatment remains the most effective therapy when feasible. At present, no medical therapies have proven efficacy in large randomized controlled trials.

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Section: Managementmentioning

confidence: 99%

Calcinosis in systemic sclerosis

Davuluri

Lood

Chung

2022

Current Opinion in Rheumatology

View full text Add to dashboard Cite

show abstract

Calcinosis in systemic sclerosis

Davuluri,

Lood,

Chung

2023

Current Opinion in Rheumatology

View full text Add to dashboard Cite

Purpose of review To provide updated information on the prevalence, pathogenesis, diagnostics, and therapeutics of calcinosis cutis associated with systemic sclerosis (SSc). Recent findings Observational studies show ethnic and geographical differences in the prevalence of calcinosis. In addition to clinical and serological associations, biochemical studies and in-vivo models have attempted to explain theories behind its pathogenesis, including prolonged state of inflammation, mechanical stress, hypoxia, and dysregulation in bone and phosphate metabolism. Long-term use of proton pump inhibitors may increase the risk for calcinosis in SSc. Few single center observational studies have shown mild benefit with minocycline and topical sodium thiosulfate. Summary Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. It affects up to 40% of SSc patients and causes significant morbidity. Long disease duration, features of vascular dysfunction, and osteoporosis have been associated with calcinosis. Altered levels of inorganic pyrophosphate and fibroblast growth factor-23 have been implicated in dysregulated phosphate metabolism that may lead to calcinosis in SSc. Plain radiography can help with diagnosis and quantifying the calcinosis burden. Surgical treatment remains the most effective therapy when feasible. At present, no medical therapies have proven efficacy in large randomized controlled trials.

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Considerations for Hand Surgery in Patients With Scleroderma

Cited by 2 publications

References 73 publications

Calcinosis in systemic sclerosis

Calcinosis in systemic sclerosis

Calcinosis in systemic sclerosis

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