title: Treatment of calcinosis cutis by extracorporeal shock-wave lithotripsy.
abstract: BACKGROUND
  Calcinosis cutis (CC) encompasses debilitating complications of connective tissue disorders and chronic venous insufficiency. Extracorporeal shock-wave lithotripsy (ESWL) is an effective treatment for urolithiasis, pancreatolithiasis, and calcified tendinitis. This study prospectively evaluated ESWL efficacy and tolerance for patients with CC.
  
  
  METHODS
  This monocentric prospective study included all consecutive patients with CC progressing for at least 3 months, while their underlying causal disease was not. They underwent 3 ESWL sessions at 3-week intervals. The CC area and associated pain (visual analog scale score and analgesic consumption) were recorded before and 6 months after ESWL.
  
  
  RESULTS
  Eight patients were included: 4 with chronic venous insufficiency, 3 with systemic scleroderma, and one with dermatomyositis. ESWL was used to treat 10 CC lesions. Seven patients completed 3 ESWL sessions. Six months after ESWL, the median CC area had decreased from 3.1 to 1.9 cm(2). visual analog scale-assessed pain scores declined dramatically, from 7 to 2 of 10, as did analgesia consumption, without any difference according to the causal disease.
  
  
  CONCLUSIONS
  Only 8 consecutive patients have been included and treated by ESWL during our study.
  
  
  CONCLUSIONS
  This evaluation of ESWL efficacy and tolerance for the treatment of CC found no difference between the different underlying CC causal diseases in terms of efficacy. Based on our observations, ESWL efficacy was better against small, ulcerated, and radiopaque CC, and it had an analgesic effect that might make subsequent surgical excision of CC fragments easier. Ergonomic adaptations are required to facilitate and expand ESWL use in dermatology.
authors: Service de Dermatologie, Hôpital Robert Debré, Centre Hospitalo-Universita de Reims, Reims, France.
authors: Nathalie
authors: N
authors: Sultan-Bichat
authors: Johann
authors: J
authors: Menard
authors: Geraldine
authors: G
authors: Perceau
authors: Frédéric
authors: F
authors: Staerman
authors: Philippe
authors: P
authors: Bernard
authors: Ziad
authors: Z
authors: Reguiaï
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000628:therapy*; D003882:Dermatomyositis / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012595:Scleroderma, Systemic / Q000628:therapy*; D012883:Skin Ulcer / Q000628:therapy; D014689:Venous Insufficiency / Q000628:therapy; D055815:Young Adult