Pseudocysts Around the Interphalangeal Joints as a Manifestation of Calcinosis Cutis in a Patient With Lupus Nephritis Undergoing Hemodialysis

Abstract

To the Editor.— We observed a patient with multiple pseudocysts around the interphalangeal joints of the hands and feet. The lesions, which developed shortly after the beginning of hemodialysis for lupus nephritis, contained toothpastelike creamy material (Fig 1). Chemical analysis disclosed the deposit to be calcium salts. Report of a Case.— In 1986, photosensitivity, arthralgia, leukopenia (lymphopenia), pleuritis, a positive lupus erythematosus cell preparation, and an abnormally high titer of antinuclear antibodies developed in a 43-year-old woman. She also had symptoms of Sjogren's syndrome. The patient was then diagnosed as having systemic lupus erythematosus (SLE). In spite of the prednisolone treatment, her renal function collapsed in 1988. Consequently, hemodialysis therapy for lupus nephritis began in August 1988, when laboratory examinations showed high levels of plasma phosphorus (2.26 to 3.62 mmol/L), slightly lower plasma calcium levels (4.0 to 5.2 mmol/L), and normal serum magnesium levels (1.32 to 1.77 mmol/L). The