title: Calcinosis cutis occurring in association with autoimmune connective tissue disease: the Mayo Clinic experience with 78 patients, 1996-2009.
abstract: OBJECTIVE
  To describe characteristics and treatment of patients with calcinosis cutis in the clinical setting of autoimmune connective tissue disease (ACTD).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Seventy-eight patients with calcinosis cutis and ACTD between 1996 and 2009.
  
  
  METHODS
  Clinical features, treatments, and outcomes of patients with calcinosis cutis in the clinical setting of ACTD.
  
  
  RESULTS
  Of 78 patients (mean age at onset of calcinosis cutis, 40.1 years), 64 (82%) were female. The following diseases were associated with calcinosis cutis: dermatomyositis (n = 30) with classic (n = 15), juvenile (n = 14), and amyopathic (n = 1) subtypes; systemic sclerosis with limited cutaneous scleroderma (n = 24); lupus panniculitis (n = 4); systemic lupus erythematosus (n = 2); mixed connective tissue disease (n = 4); overlap connective tissue disease (n = 6); undifferentiated connective tissue disease (n = 6); polymyositis (n = 1); and rheumatoid arthritis (n = 1). Therapy for calcinosis cutis consisted of medical treatment alone (n = 19), surgical therapy alone (n = 11), combined medical and surgical treatment (n = 17), no treatment (n = 30), and unknown (n = 1). Diltiazem hydrochloride was the most commonly used medical therapy, with 9 of 17 patients having a partial response. Twenty-eight patients had surgical excision of 1 or more lesions of calcinosis cutis: 22 had a complete response, 5 had a partial response, and 1 had no response.
  
  
  CONCLUSIONS
  Dermatomyositis and systemic sclerosis were the most common ACTDs associated with calcinosis cutis. Although no treatment was uniformly effective, surgical excision of symptomatic lesions and medical treatment with diltiazem provided benefit for some patients.
authors.affiliation: Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Balin
authors.forename: David A
authors.initials: DA
authors.lastname: Wetter
authors.forename: Louise K
authors.initials: LK
authors.lastname: Andersen
authors.forename: Mark D P
authors.initials: MD
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications; D001327:Autoimmune Diseases / Q000150:complications*; D002114:Calcinosis / Q000150:complications* / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003240:Connective Tissue Diseases / Q000150:complications*; D003882:Dermatomyositis / Q000150:complications; D004110:Diltiazem / Q000627:therapeutic use; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008297:Male; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000150:complications; D008947:Mixed Connective Tissue Disease / Q000150:complications; D009216:Myopia / Q000150:complications; D015435:Panniculitis, Lupus Erythematosus / Q000150:complications; D017285:Polymyositis / Q000150:complications; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000150:complications; D012871:Skin Diseases / Q000150:complications* / Q000628:therapy*; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D002121:Calcium Channel Blockers; D004110:Diltiazem