Prevalence and clinical association with calcinosis cutis in early systemic sclerosis

Abstract

Objectives Calcinosis cutis is often found with systemic sclerosis (SSc). However the calcinosis cutis and its clinical association among SSc patients is limited. Our aims were to assess the prevalence of calcinosis cutis and its association with clinical features of SSc patients at early onset of the disease. Methods A cross-sectional study on clinical characteristics and hand radiographs of 120 newly diagnosed SSc patients with the onset less than four years were evaluated. Calcinosis cutis was described based on the anatomical regions, density (level 1–3) and shapes (net, plate, stone, and amorphous). Results Among all SSc patients enrolled, 62.5% were females and 56.1% were diffuse cutaneous SSc. The mean disease duration was 2.0 ± 1.3 years. Calcinosis cutis was detected in 60 patients with the prevalence of 50% (95%confidence interval (CI), 0.41–0.59), of which 53.3% occurred at distal phalanx, 96.7% had stone shape and 48.3% were high density. Univariate analysis revealed that calcinosis cutis was associated with age (p = .02) and high-density calcinosis cutis was associated with Raynaud’s phenomenon (p = .02), ischemic ulcer (p = .04), and telangiectasis (p = .02). Logistic regression analysis revealed that calcinosis cutis at distal phalanx was negatively associated with edema at the onset (odds ratio, 0.09). Conclusion Occult calcinosis cutis can be detected by hand radiograph in one half of SSc patients at early onset of the disease. Elderly patient has a risk for calcinosis cutis development and Raynaud’s phenomenon was associated with high density calcinosis cutis. Calcinosis cutis, particularly at distal phalanx was less likely to be detected in an edematous phase of disease.

Calcinosis in Rheumatic Disease Is Still an Unmet Need: A Retrospective Single-Center Study

“…Previous studies have also reported a higher likelihood of calcinosis development in SSc patients with longer disease duration, typically around 7–10 years [ 34 ]. In contrast, despite Muktabhant et al suggesting a potential higher risk of early calcinosis development in elderly patients [ 35 ], our cohort did not show age-related differences. The association between DU and calcinosis aligns with prior research indicating a higher likelihood of calcinosis in patients with severe vascular digital involvement [ 3 ].…”

Hands and feet radiologic involvements in systemic sclerosis

“…Prevalence of hand calcinosis in our series (6.9%) is lower than that reported in previous studies (10%–37.8%) [ 3 – 7 , 9 , 12 , 13 , 16 , 17 , 23 , 24 , 33 ]. But it is nearly in agreement with the recent study of Sakata and coworkers (10%) from Japan in 2019.…”

Calcinosis Cutis and Calciphylaxis in Autoimmune Connective Tissue Diseases

“…They also confirmed a strong association between calcinosis and digital ischemia. A recent study by Muktabhant et al [ 37 ] aimed to identify common clinical features between SSc patients with and without calcinosis cutis and reported that patients with calcinosis cutis were significantly older than those without calcinosis cutis (every one-year increase of age provided the OR of calcinosis cutis detection of 1.05; 95% CI, 1.01–1.09). Interestingly, no association was found with the SSc subset or serology.…”