Adult-Onset Dermatomyositis Complicated by Calcinosis Cutis
Adult-Onset Dermatomyositis Complicated by Calcinosis Cutis
A 25-year-old African American woman with a four-year history of dermatomyositis (DM) presented with an ulcer in the right popliteal fossa of five weeks duration. Initially, the patient was diagnosed with DM based on typical heliotrope rash, photosensitivity, high creatinine kinase (CK), and interstitial lung disease. Her serology for other connective tissue diseases was negative. She was initially treated with oral prednisone 1mg/Kg/d. After normalization of CK levels, prednisone was tapered to 10mg/d but never discontinued. Two years later, she developed calcium deposits on the hips bilaterally. Over the past year, she developed dystrophic calcinosis cutis complicated by chronic skin ulcers.
The patient's past medical history is significant for bronchiolitis obliterance organizing pneumonia, gastroesophageal reflux disease, small joint polyarthritis, septic arthritis status/post arthroscopy, and chronic skin ulcers.
Her medications include prednisone 10mg/day, a calcium supplement, mycophenolate, alendronate sodium, celecoxib, and famotidine.
A 25-year-old African American woman with a four-year history of dermatomyositis (DM) presented with an ulcer in the right popliteal fossa of five weeks duration. Initially, the patient was diagnosed with DM based on typical heliotrope rash, photosensitivity, high creatinine kinase (CK), and interstitial lung disease. Her serology for other connective tissue diseases was negative. She was initially treated with oral prednisone 1mg/Kg/d. After normalization of CK levels, prednisone was tapered to 10mg/d but never discontinued. Two years later, she developed calcium deposits on the hips bilaterally. Over the past year, she developed dystrophic calcinosis cutis complicated by chronic skin ulcers.
The patient's past medical history is significant for bronchiolitis obliterance organizing pneumonia, gastroesophageal reflux disease, small joint polyarthritis, septic arthritis status/post arthroscopy, and chronic skin ulcers.
Her medications include prednisone 10mg/day, a calcium supplement, mycophenolate, alendronate sodium, celecoxib, and famotidine.
