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Topical Sodium Thiosulfate Therapy for Leg Ulcers With Dystrophic Calcification
Elizabeth K. Wolf, MD;
Aimee C. Smidt, MD;
Anne E. Laumann, MBChB, MRCP(UK)
Arch Dermatol. 2008;144(12):1560-1562.
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REPORT OF A CASE
A 41-year-old African American woman with a 14-year history of systemic lupus erythematosus (SLE) presented with exquisitely painful stellate ulcers with surrounding livedo reticularis on both shins in April 2006. In addition to small-vessel involvement, her connective tissue disease was characterized by pulmonary fibrosis, pulmonary hypertension requiring continuous oxygen supplementation, Raynaud phenomenon, and chronic right popliteal deep venous thrombosis. Her medications included prednisone (5 mg/d), methotrexate (12.5 mg/wk), folic acid, hydroxychloroquine, pentoxyphilline, coumadin, budesonide inhaler, fluticasone inhaler, fexofenadine, erythropoietin, sildenafil, amlodipine, gabapentin, acetaminophen-codeine, tramadol hydrochloride, famciclovir, tolterodine, calcium supplement, vitamin E supplement, alendronate, and esomeprazole. The results of laboratory tests were remarkable for the following values: hemoglobin, 8.8 g/dL (to convert to grams per liter, multiply by 10.0); hematocrit, 27.1% (reference range, 34%-45%); antinuclear antibody, 1:1280 speckled; double-stranded DNA, 52.1 IU/mL (reference value, <5 IU/mL); nRNP/Sm IgG . . . [Full Text of this Article]
THERAPEUTIC CHALLENGE
SOLUTION
COMMENT
AUTHOR INFORMATION
Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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