Identification of Clinical Features and Autoantibodies Associated With Calcinosis in Dermatomyositis
- Autores: Antonia Valenzuela, Lorinda Chung, Livia Casciola-Rosen, David Fiorentino
- Localización: JAMA Dermatology, ISSN 2168-6068, Vol. 150, Nº. 7, 2014, págs. 724-729
- Idioma: inglés
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Resumen
Importance Prior studies have estimated that up to 20% of adults with dermatomyositis (DM) have calcinosis, which can lead to significant morbidity. Identification of risk factors may provide a better understanding of the pathogenesis and ultimately therapy for this difficult clinical problem. Risk factors for calcinosis in adults with DM have not been extensively studied.
Objectives To determine the prevalence of calcinosis and to identify associated clinical features in a cohort of extensively phenotyped adults with DM.
Design, Setting, and Participants A cross-sectional study of 126 patients diagnosed as having DM from January 1, 2006, through January 1, 2013, was performed. Patients were adults (?18 years of age) attending the Stanford University Medical Center clinic.
Main Outcomes and Measures Calcinosis, defined as the presence of calcium deposition in the skin and subcutaneous tissues on physical examination.
Results Fourteen patients (11.1%) had calcinosis, with the extremities most commonly involved. Patients with vs those without calcinosis had a longer disease duration (median, 6.9 years; range, 2.4-18.1; vs median, 3.9 years; range, 0.2-19.2 years; P?=?.003) and more fingertip ulcers (50.0% vs 9.3%, P?
Conclusions and Relevance Calcinosis was a relatively uncommon clinical feature in our cohort of adults with DM. Our data suggest that calcinosis is positively associated with longer disease duration, fingertip ulcers, and NXP-2 autoantibodies and negatively associated with transcriptional intermediary factor 1-? antibodies. A common vascular mechanism may underlie the development of both calcinosis and fingertip ulcers in patients with DM.
