Search Our Scientific Publications & Authors

Arthritis Care Res (Hoboken) 2019 Feb 4. Epub 2019 Feb 4.

University of California, San Francisco.

Objective: Ultraviolet radiation (UVR) is considered to be an important environmental factor in the clinical course of children with JDM. We aimed to evaluate the association between UVR and severe disease outcomes in JDM.

Methods: This is a cross-sectional study of JDM subjects enrolled in the U. Read More

Dermatol Online J 2018 Nov 15;24(11). Epub 2018 Nov 15.

Northwestern University, Department of Dermatology, Chicago, Illinois.

Calcinosis cutis results from the deposition of insoluble calcium salts in the skin and subcutaneous tissue. Herein, we report a case of extensive metastatic calcinosis cutis in an 18-year-old woman with stage IV Hodgkin lymphoma with skeletal involvement. With combination therapy including radiation directed at her lymphoma and diltiazem, her lesions improved dramatically. Read More

Dermatol Online J 2018 Dec 15;24(12). Epub 2018 Dec 15.

The Ronald O. Perelman Department of Dermatology, New York University Langone Health, New York, New York Yale University School of Medicine, New Haven, Connecticut.

Calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia (CREST) syndrome is a form of a rare, clinical subtype of systemic sclerosis, known as limited systemic sclerosis. Limited systemic sclerosis, including CREST syndrome, manifests as fibrotic skin changes restricted to the hands and face, with vascular, musculoskeletal, and visceral involvement. We present a case of a 75-year-old woman with a longstanding history of CREST syndrome complicated by a digital ulceration and persistent pain associated with recalcitrant Raynaud phenomenon. Read More

Orbit 2019 Jan 15:1-3. Epub 2019 Jan 15.

a Department of Ophthalmology and Visual Sciences , Moran Eye Center, University of Utah Health Sciences Center , Salt Lake City , UT , USA.

Idiopathic subepidermal calcinosis, also known as idiopathic calcinosis cutis, is a rare condition, which typically presents as a small, hard, subepithelial mass in the absence of systemic disease and trauma. We report on an atypical case of idiopathic calcinosis, which appeared in an otherwise healthy 61-year-old female along the tarsus of her right upper eyelid. The purpose of this case report is to demonstrate idiopathic calcinosis in an unusual location that is deep to the dermis and to discuss the vast differential diagnosis of this entity. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2018 Nov;43(11):1251-1256

Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha 410013, China.

Calcific uremic arteriopathy (CUA), termed calciphylaxis, is a rare but highly fatal clinical syndrome. There is no clearly laboratory diagnostic criteria for CUA. The medium and small arterial calcification and microthrombosis discovered by skin biopsy, radiologic imaging，bone scan and the evidence of activation of the bone morphogenetic protein signal (BMPs) transduction pathway are useful for early diagnosis of this disease. Read More

Autoimmun Rev 2019 Jan 11. Epub 2019 Jan 11.

Department of Clinical Immunology and Rheumatology, Pontificia Universidad Católica de Chile, Chile.

Objective: To analyze the effectiveness and safety of rituximab (RTX) for the treatment of refractory systemic sclerosis (SSc)-associated calcinosis.

Methods: We undertook an observational study of patients with this complication treated with 1 or more cycles of RTX (1 g × 2 weeks) and evaluated for at least 12 months after RTX treatment in a single center. The primary outcome measures of the study were the improvement of calcinosis symptoms (pain, signs of local inflammation, and new episodes of skin ulceration) and the radiologic evolution of the calcification(s). Read More

Arch Craniofac Surg 2018 Dec 27;19(4):287-290. Epub 2018 Dec 27.

Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea.

Tumoral calcinosis is a condition characterized by deposition of calcium salts in the skin and sub- cutaneous tissue, commonly found around the joints. However, tumoral calcinosis of the auricle is extremely rare. We present the case of a 13-year-old boy with tumoral calcinosis of the helix of the ear auricle. Read More

Pediatr Rheumatol Online J 2018 Dec 29;16(1):84. Epub 2018 Dec 29.

Division of Pediatric Rheumatology, Department of Pediatrics, St. Louis, MO, USA.

Background: Few risk factors have been identified for the development of calcinosis among patients with Juvenile Dermatomyositis, and currently no clinical phenotype has been associated with its development. We analyzed a large database of patients to further elucidate any relationships among patients with and without calcinosis.

Method: The CARRA legacy registry recruited pediatric rheumatology patients from 55 centers across North America from 2010 through 2014, including over 650 subjects with Juvenile Dermatomyositis. Read More

J Low Genit Tract Dis 2019 Jan;23(1):75-76

Department of Pathology & Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, NJ.

Idiopathic calcinosis cutis (CC) is an uncommon skin condition. Although it has been reported many times in the scrotum, it is exceedingly rare in the vulva. Most reports of vulvar CC are in children. Read More

APMIS 2019 Jan;127(1):41-44

Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic.

We report a very rare case of Streptococcus canis native infective endocarditis in a 73-year-old woman living in close contact with her dog. Her echocardiography showed large calcifications in the mitral annulus, massive regurgitation below the posterior leaflet, and adjacent vegetation. Blood culture was positive for Streptococcus Lancefield group G. Read More

J Med Case Rep 2018 Dec 12;12(1):366. Epub 2018 Dec 12.

Department of Dermatology and Venereology, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal.

Background: Abnormal deposition of calcium in the skin or subcutaneous tissue is termed calcinosis cutis. Idiopathic calcinosis cutis of the scrotum is an uncommon entity. The pathogenesis of idiopathic calcinosis cutis of the scrotum is debatable. Read More

JAMA Dermatol 2018 Nov 21. Epub 2018 Nov 21.

Division of Dermatology, Department of Medicine, The Ohio State University, Columbus.

Vet Dermatol 2019 Feb 21;30(1):56-e15. Epub 2018 Nov 21.

Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124, Pisa, Italy.

Background: It is commonly accepted that canine dystrophic mineralization of the hair follicle glassy membrane can be seen in hyperadrenocorticism and as a senile change in poodles. Pathology textbooks define this change as deposition of calcium salts in the form of basophilic, amorphous, granular material along collagen fibrils.

Hypothesis/objectives: The aim was to evaluate whether the incidence of the lesion is specific to poodles and if it is always associated with calcium deposition. Read More

BMJ Case Rep 2018 Oct 24;2018. Epub 2018 Oct 24.

Medicine; Endocrinology, Diabetes and Nutrition, University of Maryland Medical Center, Baltimore, Maryland, USA.

Calciphylaxis is a rare and life-threatening disease characterized by cutaneous arteriolar stenosis and vascular thrombosis leading to skin ischaemia and necrosis. While calciphylaxis occurs mostly in patients with end-stage renal disease, the disorder has been described in patients with normal renal function, namely non-uraemic calciphylaxis (NUC). A 41-year-old African-American woman presented with a painful ulcerative rash on her thighs and right buttock 2 months after undergoing an orthotopic liver transplantation. Read More

Am J Med Sci 2018 Oct 13;356(4):e35. Epub 2018 Jun 13.

Department of Rheumatology, State University of New York Downstate Medical Center, Brooklyn, New York. Electronic address:

Cureus 2018 Aug 21;10(8):e3170. Epub 2018 Aug 21.

Dermatologist, San Diego Family Dermatology, San Diego, USA.

Osteoma cutis is the formation of bone within the skin. It can present as either primary osteoma cutis or secondary osteoma cutis. Secondary osteoma cutis is more common and is associated with inflammatory, infectious, and neoplastic disorders, including basal cell carcinoma. Read More

Front Pediatr 2018 9;6:284. Epub 2018 Oct 9.

Department of Pediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom.

Juvenile dermatomyositis (JDM) is a rare autoimmune disease mainly characterized by muscle and skin involvement. Vasculopathy is considered central to the pathogenesis of the disease. The exact nature of vasculopathy is not yet understood but it is a complex process with both an inflammatory and a non-inflammatory, occlusive component. Read More

Best Pract Res Clin Gastroenterol 2018 Jun - Aug;34-35:49-54. Epub 2018 May 23.

Dept. of Surgery, Oncology and Gastroenterology, University of Padova, Italy.

Patients with PBC have at least 60% of probability to have an autoimmune extrahepatic condition. The pathogenesis of these conditions includes a common mechanism involving both innate and adaptive immune responses targeting cholangiocytes and different extrahepatic tissues. The recent EASL guidelines recommend the management of these conditions, although detailed practical treatments have not been indicated. Read More

J Cutan Pathol 2019 Jan 12;46(1):84-87. Epub 2018 Nov 12.

Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Acquired perforating calcific collagenosis (APCC), which is characterized by the calcification of dermal collagen fibers with subsequent transepidermal elimination and perforation, is an extremely rare entity. Thus far, it has only been reported in a patient with direct contact exposure to calcium chloride. Here, we report a unique case of APCC occurring in a drug addict admitted for rhabdomyolysis. Read More

QJM 2019 Jan;112(1):29-34

Division of Nephrology, Department of Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.

Calciphylaxis is a disease of significant morbidity and mortality, predominantly affecting dialysis patients. The term 'calciphylaxis' was coined by Seyle et al. in 1961 to describe calcium deposition in the skin and subcutaneous soft tissue of uremic rats in response to 'triggers' (e. Read More

J Dtsch Dermatol Ges 2018 Oct;16(10):1289-1295

Department of Pediatrics and Adolescent Medicine, Division of Pediatric Endocrinology and Diabetology, Saarland University Medical Center, Homburg, Germany.

With an incidence of 1 in 700 births, Down syndrome (DS) is not an uncommon condition. It is associated with various disorders of different organ systems. Serious disorders include cardiac defects and leukemia. Read More

J Dtsch Dermatol Ges 2018 Oct;16(10):1289-1296

Universität des Saarlandes, Kliniken für Kinder- und Jugendmedizin, Sektion Pädiatrische Endokrinologie und Diabetologie, Homburg.

Das Down-Syndrom (DS) ist mit einer Inzidenz von 1 : 700 aller Geburten nicht selten und mit diversen Erkrankungen unterschiedlicher Organsysteme assoziiert. Zu den schwerwiegenden Erkrankungen zählen Herzfehler und Leukämie. Letztere zeigt sich im Neugeborenenalter und geht nicht immer in eine klassische myeloische Leukämie über (transiente myeloproliferative Erkrankung). Read More

Int J Low Extrem Wounds 2018 Dec 1;17(4):282-284. Epub 2018 Oct 1.

1 Department of Dermatology, Kocaeli University School of Medicine, Kocaeli, Turkey.

Leg ulcers are not a disease themselves, they are a symptom of a disease. To manage them properly, finding the correct diagnosis of the disease is mandatory. Our case is a model to underline that leg ulcers are a significant burden for the patient, because leg ulcer got ahead of the patient's other serious complaints such as Raynaud's phenomenon or sclerodactyly. Read More

Clin Exp Dermatol 2018 Sep 25. Epub 2018 Sep 25.

Department of Dermatology, Mayo Clinic, Rochester, MN, USA.

In this case series, we retrospectively identified all patients treated with topical sodium thiosulfate (TST) for calcinosis cutis (CC) associated with underlying autoimmune connective tissue diseases at Mayo Clinic (Rochester, MN, USA) during the period 1 January 2012 to 27 June 2017. Of 28 patients identified (mean age 57.0 years; 96% female), 19 (68%) had clinical improvement of their CC with TST, 7 (25%) had no response and 2 (7%) had unknown response. Read More

Medicine (Baltimore) 2018 Sep;97(38):e12517

Department of Orthopaedic Surgery, Kyung Hee University Hospital, College of medicine, Kyung Hee University, Seoul, Korea.

Rationale: Calcific myonecrosis is a very rare late sequela that occurs in patients who have had trauma accompanied by vascular compromise, in which a single muscle or entire muscles in a compartment undergoes necrosis and form a calcified mass. It is mostly a benign entity, but some cases cause bone destruction and form non-healing chronic sinuses. In such cases, wound management becomes difficult and there is a potential risk of secondary infection. Read More

Retin Cases Brief Rep 2018 Fall;12(4):331-335

Vitreous Retina Macula Consultants of New York, New York.

Purpose: To report the posterior segment and retinal vascular manifestations of calcific uremic arteriolopathy (calciphylaxis). Clinical findings are correlated with multimodal imaging results.

Methods: Observational case report. Read More

J Dermatol 2018 Sep 8. Epub 2018 Sep 8.

Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan.

Curr Opin Rheumatol 2018 Nov;30(6):554-561

Stanford University School of Medicine and Palo Alto VA Healthcare System, Division of Immunology and Rheumatology, and Dermatology, Palo Alto, California, USA.

Purpose Of Review: To provide an update on the available literature regarding the epidemiology, pathophysiology, diagnosis, and treatment of calcinosis cutis in patients with systemic sclerosis (SSc).

Recent Findings: We identified observational studies that describe the frequency of calcinosis in SSc and associated clinical features; molecular studies exploring potential pathogenic mechanisms; and case reports and case series describing new diagnostic approaches and treatments.

Summary: Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. Read More

Am J Dermatopathol 2018 09;40(9):704-706

Department of Cellular Pathology, Hospital El Bierzo, Ponferrada, Spain.

Clin Neuropathol 2018 Nov/Dec;37(6):277-282

Dyskeratosis congenita (DKC) is a rare, inherited disorder classically known by the triad of nail dystrophy, mucosal leukoplakia, and lacy reticulated skin hyperpigmentation. Bone marrow failure is a prominent feature and accounts for most deaths in these patients. Genetic mutations resulting in shortened telomeres have been shown to cause DKC, which is the basis for categorizing it as a "premature aging syndrome". Read More

Dtsch Med Wochenschr 2018 Aug 7;143(16):1155-1156. Epub 2018 Aug 7.

Klinik für Innere Medizin und Nephrologie, Universitätsklinikum Marburg.

Clin Dermatol 2018 Jul - Aug;36(4):459-474. Epub 2018 Apr 12.

Corporal Michael J. Crescenz VAMC, Philadelphia, Pennsylvania, USA; Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Systemic sclerosis is an uncommon autoimmune connective tissue disease with multiorgan system involvement and significant associated morbidity and mortality. Cutaneous signs and clinical manifestations are of particular importance, as they may be recognized before systemic manifestations, allowing earlier risk stratification into the limited and diffuse cutaneous subtypes, as well as earlier initiation of treatment. Important cutaneous manifestations include Raynaud's phenomenon, digital ulcers, cutaneous sclerosis, calcinosis cutis, telangiectasias, pruritus, and dyspigmentation. Read More

Clin Cosmet Investig Dermatol 2018 11;11:333-337. Epub 2018 Jul 11.

Department of Internal Medicine, LAUTECH Teaching Hospital, Ogbomoso, Oyo, Nigeria.

Introduction: Idiopathic scrotal calcinosis is a benign and rare disease of the scrotal skin that presents as solitary or multiple asymptomatic calcified nodules in the absence of systemic disorders of calcium/phosphorus balance.

Case Reports: We report the management of 2 cases and review the literature with comments on factors that determine acceptance or otherwise of surgical treatment. Our patients were 29 and 33 years old and presented with nodular scrotal lesions. Read More

J Cutan Pathol 2018 Oct 3;45(10):786-790. Epub 2018 Aug 3.

Department of Pathology, Section of Dermatopathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas.

Small-molecule inhibitors (nibs) have revolutionized cancer therapy with the emergence of clinically efficacious treatment for advanced-stage malignancies. Fibroblast growth factor receptor (FGFR) inhibitors have shown therapeutic efficacy in malignancies with molecular-genetic alterations in the FGFR/fibroblast growth factor pathway. In a phase 1 clinical trial, erdafitinib, a pan FGFR inhibitor, was well tolerated with a manageable toxicity profile. Read More

Mod Rheumatol 2018 Sep 25:1-6. Epub 2018 Sep 25.

g Department of Biochemistry , Dokuz Eylul University School of Medicine , Izmir , Turkey.

Objectives: We explored the interactions of osteoprotegerin (OPG) with biomarkers of bone turnover and cytokines, including soluble receptor activator for nuclear factor kappa beta ligand (sRANKL), tumor necrosis factor-related apoptosis-induced ligand (TRAIL), and Wnt inhibitors in osteoporosis, vasculopathy and fibrosis related to systemic sclerosis (SSc).

Methods: The study included 46 SSc patients and 30 healthy controls. Skin thickness, pulmonary fibrosis and/or hypertension, digital ulcers, and calcinosis cutis of SSc patients were assessed. Read More

Medicine (Baltimore) 2018 Jul;97(27):e11300

University of Medicine and Pharmacy Grigore T. Popa Iasi.

Rationale: Though to be rare, calcific uremic arteriolophathy (CUA) is an ectopic calcification entity causing pain and disabilities in patients with chronic renal insufficiency, thus increasing the morbidity and mortality.

Patient Concern: We report a case of four years old boy admitted with acute respiratory failure. Physical examination revealed: irritability, purple subcutaneous hard nodules, tachypnea, dry spasmodic cough, respiratory rate 45/min, heart rate 110/min, blood pressure 100/60 mmHg, with normal heart sounds, no murmurs, hepatomegaly with hepato-jugular reflux. Read More

Pediatr Dermatol 2018 Sep 26;35(5):e276-e280. Epub 2018 Jun 26.

Dermatology Department, University Hospital La Paz, Madrid, Spain.

High-frequency ultrasonography is a bedside tool increasingly used for the assessment of skin lesions, but there have been few reports about its importance in children with skin signs of hematologic disease. We present three cases to highlight the usefulness of high-frequency ultrasonography in assisting with the diagnosis of these skin lesions. Read More

Plast Reconstr Surg 2018 09;142(3):699-707

A Coruña, Spain From the Plastic Surgery Department, Rheumatology Department, and Pathology Department, Experimental Surgery Unit, Instituto de Investigación Biomédica de A Coruña, and the Radiology Department, Breast Pathology Service, Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde, Universidade de A Coruña.

Background: Calcium gluconate extravasation is a process that can cause serious lesions, such as necrosis and calcification of the soft tissues. The aim of the present study was to analyze the beneficial effects of four possible local antidotes for calcium gluconate extravasation: hyaluronidase, sodium thiosulfate, triamcinolone acetonide, and physiologic saline solution.

Methods: Seventy-four BALB/c mice were used in the study. Read More

Pediatr Rheumatol Online J 2018 Jun 20;16(1):38. Epub 2018 Jun 20.

German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany.

Background: Juvenile Dermatomyositis (JDM) is a rare pediatric autoimmune disease with broad variations of the individual course. Data on the optimal management are mostly lacking. Currently treatment decisions are often based on experts' opinions. Read More

An Bras Dermatol 2018 Jun;93(3):397-404

Dermatology Department, University Hospital "Dr. José Eleuterio González", Nuevo León, México, México.

Purpura is defined as a visible hemorrhage in the skin or mucosa, which is not evanescent upon pressure. Proper classification allows a better patient approach due to its multiple diagnoses. Purpuras can be categorized by size, morphology, and other characteristics. Read More

Br J Dermatol 2018 Jun;178(6):1243-1245

Dermatology Administration, Perelman Center for Advanced Medicine, University of Pennsylvania, 7th Floor, South Tower, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, U.S.A.

Acta Derm Venereol 2018 Jun;98(6):614-615

Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.

Med Hypotheses 2018 Jul 2;116:101-104. Epub 2018 May 2.

Centre for Musculoskeletal Research, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; NIHR Manchester Biomedical Research Centre, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, UK.

Digital ulcers (DU) are a common manifestation of systemic sclerosis (SSc) and occur at a variety of locations including the fingertips and over the extensor aspects of the hands. However, most recent clinical trials have included only fingertip DUs as these are believed to be ischaemic in aetiology, and therefore likely to benefit from treatment with vasoactive drug therapies. There is an emerging evidence base to suggest that all DUs in SSc could share an ischaemic component which is potentially responsive to vascular therapy. Read More

Am J Clin Dermatol 2018 Aug;19(4):599-608

Department of Dermatology, University Hospital "Dr. José Eleuterio González", Autonomous University of Nuevo León, Av. Madero y Gonzalitos S/N 64460 Col. Mitras Centro, Monterrey, Mexico.

Calciphylaxis, also known as calcific uremic arteriolopathy and uremic small artery disease with medial wall calcification and intimal hyperplasia, is a multifactorial cutaneous vascular disease characterized by chronic, painful, non-healing wounds that occur frequently in patients with chronic kidney disease, predominantly in those with end-stage renal disease. The pathogenesis remains unclear, and the development of calciphylaxis lesions depends on medial calcification, intimal fibrosis of arterioles and thrombotic occlusion. Despite an increase in reports of calciphylaxis in the literature and clinical recognition of demographic characteristics and risk factors associated with calciphylaxis, it remains a poorly understood disease with high morbidity and mortality. Read More

Reumatol Clin 2018 May 21. Epub 2018 May 21.

Servicio de Radiodiagnóstico, Hospital General Universitario de Ciudad Real, Ciudad Real, España.

Heterotopic ossification is an uncommon disorder that consists of deposition of ectopic bone outside the extraskeletal tissues. In the skin, it can be primary, in association with genetic syndromes, or be secondary to different disorders. The latter include subcutaneous ossification of the legs in chronic venousinsufficiency, an infrequent and unrecognized complication. Read More

J Dermatol 2018 Nov 14;45(11):e314-e316. Epub 2018 May 14.

Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan.

Neurology 2018 Jun 4;90(23):e2068-e2076. Epub 2018 May 4.

From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (R.D.L., I.P.-F., W.H., J.C.M., M.C.-D., A.L.M.), NIH, Bethesda; and Johns Hopkins University School of Medicine (I.P.-F., J.A., E.T., C.J., M.C.-D., A.M.C., S.K.D., L.C.-S., J.J.P., A.L.M.), Baltimore, MD.

Objective: To define the clinical features of myositis patients with anti-PM/Scl-75 and/or anti-PM/Scl-100 autoantibodies at disease onset and during the course of disease and compare them to patients with other forms of myositis.

Methods: In this longitudinal cohort study, the prevalence and severity of clinical features at disease onset and during follow-up were compared between anti-PM/Scl-positive patients and those with the antisynthetase syndrome (AS), dermatomyositis (DM), and immune-mediated necrotizing myopathy (IMNM).

Results: Forty-one anti-PM/Scl-positive, 132 AS, 178 DM, and 135 IMNM patients were included. Read More

Malays Orthop J 2018 Mar;12(1):66-68

Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Cheras, Malaysia.

Calcinosis cutis is a rare presentation and not many cases have been reported especially of idiopathic type. We are reporting a case of idiopathic calcinosis cutis of lower limbs in a 33-year old female who presented to our clinic for multiple painless swellings over her lower limbs for the past six months, without any history of trauma or infection. We have decided to observe her condition on regular follow-up and conservative management. Read More

J Hand Surg Am 2018 Jun;43(6):550-557

Department of Plastic and Reconstructive Surgery, Johns Hopkins Medicine, Baltimore, MD. Electronic address:

Scleroderma is a rare autoimmune connective tissue disorder that often affects the hands. Manifestations in the hands include calcium deposits within the soft tissues that cause pain and may ulcerate through the skin, digital ischemia resulting in chronic wounds and digital gangrene, and joint contracture. Because of the underlying disease, patients with scleroderma have poorly vascularized tissue and a deficient soft tissue envelope, which make surgery particularly challenging. Read More