Unusual and memorable
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A 38 year old Arab woman presented recently to the hospital with cellulitis of the left hand and ischaemia of the right second toe. Multiple, coarse, and firm cutaneous nodules in various sites of the body were also noted in the examination. She had been diagnosed with systemic lupus erythematosus/myositis overlap syndrome for approximately 10 years and had not been aware of telengiectasis, sclerodactyly or dysphagia. She has had Raynaud's phenomenon for years, but it has recently improved. Her nodules begun to develop some four to five years ago. Later, they progressed to involve the mandible, hands, arms, axilla, chest, and abdominal wall (fig 1) and the legs.
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Radiologically, the abdominal wall was the site most heavily involved by these lesions where they appeared as tumoral-like calcinosis (fig 2). The feet were spared.
| Figure Removed (Available Only in the Full Text) |
Blood test including creatine kinase and
lactate dehydrogenase, and parathormone assay, were of normal values.
Anti-nuclear factor
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