Dermatomyositis (DM) is an autoimmune connective tissue disease associated with calcinosis, uncommon in adults. A 61-year-old African Caribbean woman with a 6-year history of DM presented with a 1-year history of thickening of the skin and subcutaneous tissue of the upper limbs, the chest and abdominal wall, and both thighs. There were flexion contractures at the elbows, bilateral frozen shoulders, and muscle wasting.
Radiographs demonstrated lacy reticular subcutaneous calcification along the chest and abdominal walls and in the subcutaneous tissue and muscles of the upper limbs (Figure 1).
Lacy reticular-pattern calcinosis in the subcutaneous tissue and intramuscular region of the chest wall and upper limbs.
DM is one of the most common autoimmune connective tissue diseases associated with calcinosis, which is typically distributed in the trunk and extremities and is less prevalent, with a later onset, in adults compared to children1. The classic description is of a diffuse fine reticular-pattern calcinosis, in contrast to the localized lobular masses that may be seen in tumoral calcinosis2. The diffuse, subcutaneous, lacy, reticular calcinosis is one of 4 distinct patterns of soft-tissue calcification described in juvenile DM; however, evidence in adults is not mentioned in the literature3.
