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一名16岁女性右手拇指复发性皮肤钙化病的不寻常表现

Unusual Presentation of Recurrent Calcinosis Cutis in the Right Thumb of a 16-Year-Old Female.

作者信息

Alam Munir, ALAhmari Abdullah S, ALAhmari Ahmed S

机构信息

Plastic Surgery, King Abdullah Hospital Bisha, Bisha, SAU.

Orthopedics, Armed Forces Hospital Southern Region, Khamis Mushait, SAU.

出版信息

Cureus. 2024 May 6;16(5):e59721. doi: 10.7759/cureus.59721. eCollection 2024 May.

DOI:10.7759/cureus.59721
PMID:38840984
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11151707/
Abstract

Calcinosis cutis is a quite unusual disease represented by abnormal accumulation of calcium salts in the skin and subcutaneous tissues. Repeated cutis calcinosis means recurrent calcium deposition in pre-existing areas. The case report illustrated the case of a 16-year-old female who had recurrent calcium deposits on the base of her right thumb. The patient initially had swelling at the base of her right thumb, which had been present for six months now. The patient described the dorsal solid mass on top of the thumb base, which was painful and had reduced thumb mobility. There was swelling that became painful, specifically located at the same site as the previous surgery, with thumb restriction and superadded infection at the metacarpophalangeal joint. Routine lab tests, including blood tests and rheumatologic and autoimmune work-ups, were normal. Plain radiographs and ultrasound examinations unveiled the characteristics of calcifications in the thumb tissues. A skin biopsy was done and the calcium deposits in subcutaneous tissue were confirmed, matching calcinosis cutis. The approach to the treatment of this condition entailed conservative measures. Some included physiotherapy to correct a flexion deformity, antibiotics, painkillers, and daily dressing. The patient was advised to follow up and to consider excision of the nodules. This case points out the clinical manifestations, investigations, and initial management of available strategies for recurrent calcinosis cutis. Further studies and long-term follow-up are necessary to determine the optimal treatment approaches and outcomes for this rare condition.

摘要

皮肤钙质沉着症是一种颇为罕见的疾病,其特征为皮肤和皮下组织中钙盐异常沉积。反复性皮肤钙质沉着症意味着钙在先前存在的区域反复沉积。该病例报告讲述了一名16岁女性的情况,她右手拇指根部反复出现钙沉积。患者最初右手拇指根部肿胀,至今已持续六个月。患者描述拇指根部背侧有实性肿块,伴有疼痛且拇指活动度降低。在与先前手术相同的部位出现了肿胀并伴有疼痛,掌指关节处有拇指活动受限及继发感染。包括血液检查、风湿病学和自身免疫检查在内的常规实验室检查均正常。X线平片和超声检查揭示了拇指组织中钙化的特征。进行了皮肤活检,证实皮下组织中有钙沉积,符合皮肤钙质沉着症。这种病症的治疗方法包括保守措施。其中一些措施包括物理治疗以纠正屈曲畸形、使用抗生素、止痛药以及每日换药。建议患者进行随访并考虑切除结节。该病例指出了复发性皮肤钙质沉着症的临床表现、检查及现有治疗策略的初步处理方法。需要进一步研究和长期随访以确定这种罕见病症的最佳治疗方法和结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad3f/11151707/c2bf0e5d304e/cureus-0016-00000059721-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad3f/11151707/c63d54343894/cureus-0016-00000059721-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad3f/11151707/582ae2184ef9/cureus-0016-00000059721-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad3f/11151707/e619f8042a7c/cureus-0016-00000059721-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad3f/11151707/c2bf0e5d304e/cureus-0016-00000059721-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad3f/11151707/c63d54343894/cureus-0016-00000059721-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad3f/11151707/582ae2184ef9/cureus-0016-00000059721-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad3f/11151707/e619f8042a7c/cureus-0016-00000059721-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad3f/11151707/c2bf0e5d304e/cureus-0016-00000059721-i04.jpg

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本文引用的文献

1
Iatrogenic Calcinosis Cutis Successfully Treated with Topical Sodium Thiosulfate.外用硫代硫酸钠成功治疗医源性皮肤钙化症
Pediatr Dermatol. 2017 May;34(3):356-358. doi: 10.1111/pde.13116. Epub 2017 Apr 6.
2
Calcinosis Cutis and Calciphylaxis.皮肤钙质沉着症与钙过敏症
Actas Dermosifiliogr. 2015 Dec;106(10):785-94. doi: 10.1016/j.ad.2015.09.001. Epub 2015 Sep 26.
3
Diffuse idiopathic calcinosis cutis in an adult: a rare case.成人弥漫性特发性皮肤钙质沉着症:一例罕见病例。
Eurasian J Med. 2014 Jun;46(2):131-4. doi: 10.5152/eajm.2014.29.
4
Calcinosis cutis: part II. Treatment options.皮肤钙化病:第二部分。治疗选择。
J Am Acad Dermatol. 2011 Jul;65(1):15-22; quiz 23-4. doi: 10.1016/j.jaad.2010.08.039.
5
Calcinosis cutis: part I. Diagnostic pathway.皮肤钙化病:第一部分。诊断途径。
J Am Acad Dermatol. 2011 Jul;65(1):1-12; quiz 13-4. doi: 10.1016/j.jaad.2010.08.038.