33641 Treatments of calcinosis cutis in autoimmune connective tissue diseases

Abstract

Calcinosis cutis is often seen in the setting of autoimmune connective tissue disease (ACTD). Treatment for calcinosis cutis is often difficult and unsuccessful. We sought to evaluate outcomes at our institution of treatments for calcinosis cutis. A search in the patient data registry was conducted to select patients with the diagnosis of calcinosis cutis and ACTD at Massachusetts General Hospital and Brigham Women’s Hospital. Out of 220 charts, 43 patients were identified with adequate documentation to assess outcomes and the diagnosis of calcinosis cutis in provider notes with underlying ACTD. 86.0% of patients had some form of medical intervention and 39.5% of patients underwent surgical excision. 44.2% of patients had no response or resolution of their calcinosis in response to treatments. 39.5% of patients indicated partial resolution of calcinosis cutis. Only 25% of patients with a documented partial response was due to medical therapy. There was often no physical examination documentation from the provider demonstrating a reduction from the previous examination. In our case-series we found that results are few and far between. Complete resolution was only seen through surgical excision of nodules or through the use of sodium thiosulfate on small lesions (<3 mm). Additionally, many of the patients that were categorized as a partial reduction was largely due to self-reported improvement. In future, accurate documentation of calcinosis lesion sizes and locations by text or photographs would provide more rigorous data, rather than depending on patient self-reported improvement, which could be influenced by a placebo effect.