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#1
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07-31-2024, 05:39 PM
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Idiopathic Calcinosis Cutis in a Child
A 6-year-old female child presented to their center complaining of multiple subcutaneous nodules that had progressed to pustules and ulcers with purulent discharge, which had started about 2 years ago on her hip and subsequently spread progressively to her arms, elbows and knees. Screening tests for collagen vascular disease, including ANA, anti-DNA, anti-SM, ANCA, rheumatoid arthritis (RA) test, serum C3, C4 and CH50 levels were within normal limits. Tuberculin skin test was negative. Staphylococcus aureus was grown in bacteriological cultures of the purulent discharge. At the time of presentation, systemic therapy, such as cyclic intravenous pamidronate disodium (Aredia), was administrated every 2 months, 1 mg/kg/day for 3 days. In the follow-up time, some nodules became ulcerated and were complicated by repeated bacterial infections; some nodules required large surgical excisions and the dense chalk-like materials were removed successfully from the deposits in the hip and elbows without recurrence. intravenous pamidronate disodium was started in the same dose. Surgical excision of 3 selected fluctuant, subcutaneous nodules was performed due to severe pain and impaired mobility associated with the calcification. Recurrence did not occur. On 1-year follow-up, the current lesions had become smaller and no new lesions had appeared. After follow-up examinations over the last 2 years, the patient is still on intravenous pamidronate disodium. No new lesions have appeared and most of the old lesions have ulcerated and cicatrized. |