Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Division of Rheumatology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Mod Rheumatol. 2021 Nov;31(6):1113-1119. doi: 10.1080/14397595.2021.1886654. Epub 2021 Feb 22.
Calcinosis cutis is often found with systemic sclerosis (SSc). However the calcinosis cutis and its clinical association among SSc patients is limited. Our aims were to assess the prevalence of calcinosis cutis and its association with clinical features of SSc patients at early onset of the disease.
A cross-sectional study on clinical characteristics and hand radiographs of 120 newly diagnosed SSc patients with the onset less than four years were evaluated. Calcinosis cutis was described based on the anatomical regions, density (level 1-3) and shapes (net, plate, stone, and amorphous).
Among all SSc patients enrolled, 62.5% were females and 56.1% were diffuse cutaneous SSc. The mean disease duration was 2.0 ± 1.3 years. Calcinosis cutis was detected in 60 patients with the prevalence of 50% (95%confidence interval (CI), 0.41-0.59), of which 53.3% occurred at distal phalanx, 96.7% had stone shape and 48.3% were high density. Univariate analysis revealed that calcinosis cutis was associated with age ( = .02) and high-density calcinosis cutis was associated with Raynaud's phenomenon ( = .02), ischemic ulcer ( = .04), and telangiectasis ( = .02). Logistic regression analysis revealed that calcinosis cutis at distal phalanx was negatively associated with edema at the onset (odds ratio, 0.09).
Occult calcinosis cutis can be detected by hand radiograph in one half of SSc patients at early onset of the disease. Elderly patient has a risk for calcinosis cutis development and Raynaud's phenomenon was associated with high density calcinosis cutis. Calcinosis cutis, particularly at distal phalanx was less likely to be detected in an edematous phase of disease.
硬皮病患者常伴有皮肤钙化。然而，硬皮病患者的皮肤钙化及其临床相关性尚不清楚。我们的目的是评估疾病早期发病的硬皮病患者皮肤钙化的患病率及其与临床特征的相关性。
对 120 例发病时间少于 4 年的新诊断硬皮病患者的临床特征和手部 X 线片进行了横断面研究。根据解剖部位、密度（1-3 级）和形状（网状、板状、结石状和无定形）描述皮肤钙化。
所有入组的硬皮病患者中，女性占 62.5%，弥漫性皮肤硬皮病占 56.1%。平均病程为 2.0±1.3 年。在 60 例患者中发现了皮肤钙化，患病率为 50%（95%置信区间，0.41-0.59），其中 53.3%发生在指末节，96.7%为结石状，48.3%为高密度。单因素分析显示，皮肤钙化与年龄（ = .02）有关，高密度皮肤钙化与雷诺现象（ = .02）、缺血性溃疡（ = .04）和毛细血管扩张（ = .02）有关。Logistic 回归分析显示，指末节皮肤钙化与疾病初发时的水肿呈负相关（比值比，0.09）。
在疾病早期发病的硬皮病患者中，通过手部 X 线片可检测到隐匿性皮肤钙化。老年患者发生皮肤钙化的风险增加，而雷诺现象与高密度皮肤钙化有关。疾病的水肿期，尤其是指末节，不太可能检测到皮肤钙化。
