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Dermatomyositis presenting with diffuse calcinosis
  1. Madalyn Walsh1,
  2. Brittany Bettendorf2 and
  3. Carleigh Zahn3
  1. 1Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  2. 2Division of Immunology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  3. 3Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Madalyn Walsh; madalyn-walsh{at}uiowa.edu

Abstract

We present the case of a woman in her early 50s who initially presented to an orthopedist for nodules located near the posterior knee. Imaging revealed diffuse subcutaneous calcifications and she was subsequently referred to rheumatology. Additional testing included myositis panel, electromyography (EMG) and muscle biopsy which indicated the presence of an inflammatory myopathy. It was determined that this patient had an uncommon presentation of dermatomyositis in which her primary complaint was calcinosis cutis. While rash and muscle weakness are often the symptoms most commonly associated with dermatomyositis, it is essential to have a wide differential for patients presenting with calcium deposition in soft tissues. This is particularly important in patients with certain antibodies, including the NXP-2 antibody, which can be associated with malignancy and should prompt an appropriate malignancy workup.

  • Rheumatology
  • Radiology

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: MW, CZ, BB. The following authors gave final approval of the manuscript: MW, CZ, BB.

  • Funding This study was funded by Roy J and Lucille A Carver College of Medicine, University of Iowa (NA).

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.