i’ve got you under my skin

No, I’m not talking about the Cole Porter song… I’m talking about a very painful symptom of dermatomyositis:

calcinosis

[kal′sənō′sis]
a condition characterized by abnormal deposits of calcium salts in various tissues. The deposits appear as nodules or plaques and may occur in the skin, connective tissue, muscles, or intervertebral disks. Usually the nodules occur secondary to dermatomyositis or to a preexisting inflammatory degenerative or neoplastic dermatosis, primarily scleroderma.

From the TMA website, here’s an excerpt from Dermatomyositis by Jeffrey P. Callen, MD, Robert L. Wortmann, MD (Division of Dermatology, University of Louisville School of Medicine, Louisville, KY 40202, USA Department of Medicine, University of Oklahoma College of Medicine, Tulsa, OK 74135-2553, US):

Calcinosis of the skin or muscle is unusual in adults, but
may occur in up to 40% of children or adolescents with DM.
Calcinosis cutis is manifested by firm, yellow, or flesh-
colored nodules, often over bony prominences. Occasion-
ally, these nodules can extrude through the surface of the
skin, in which case secondary infection may occur.
Calcification of the muscles is often asymptomatic and
may be seen only on radiologic examination. In severe forms,
the calcinosis can cause loss of function, and, rarely bone formation is possible.
  (click here for the full pdf of this clinic)
Screen Shot 2014-01-08 at 9.05.57 AM Screen Shot 2014-01-08 at 9.06.38 AM
The calcium deposits can be found anywhere in the body, usually in the subcutaneous layer. Think of them like kidney stones, but on your hands, arms, legs, neck, face, etc. Again, PAINFUL!!!

Calcinosis is a fairly rare symptom of myositis, but sadly it is most prevalent in children and adolescents. Heartbreaking, right? Here is what Cure JM has to say:

  • Researchers believe approximately 20% to one-third of the children with JM will develop calcinosis. Calcinosis is the development of small lumps or linear deposits of calcium under the skin or in the muscle. They may feel like rocks under the skin and can range in size from a small pebble to a large softball. They can also form in a sheet-like appearance.

 

  • In many cases, these calcium deposits can grow over time or remain unchanged for years. In some cases, the calcinosis lumps are absorbed back into the body. Other times, the lumps break through the skin where they may leak creamy white calcium. These protrusions can become infected and painful, and sometimes need to be surgically removed. Calcinosis lumps are most likely to break through on the joints, such as the elbows and knees, but they can emerge anywhere on the body, often in pressure points.

 

  • Calcinosis can be present at the time of diagnosis, or many years later. It can be associated with a delayed diagnosis or the lack of aggressive treatment.

 

There is currently NO cure for calcinosis, and treatment options seem limited. I tried to look up some discussion boards that talk about calcinosis, looks like The Scleroderma Foundation is the best bet with over 343 results (you need to be a member to view the discussions, but membership is free) click here.

If you do suffer from calcinosis, and would like to write about your personal experiences with this painful symptom on Myositis Colorado please let us know – we would love to learn more! Email us: myositisco@gmail.com.

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