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VIGNETTES
Surgical Debridement of Painful Fingertip Calcinosis Cutis in CREST Syndrome
Nicole Saddic, MS;
Jeffrey J. Miller, MD;
O. Fred Miller III, MD;
Jennie T. Clarke, MD
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Painful fingertip calcinosis cutis causes substantial morbidity in patients with CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia), also called limited cutaneous scleroderma. Medical therapy for this condition is uniformly disappointing.
Report of a Case
A 58-year-old man with CREST syndrome for the past 20 years presented with a 3-week history of a painful digital hyperkeratotic plaque on the tip of his left hand’s third finger (Figure 1A and Figure 2). Medical treatments, including nifedipine, colchicine, pentoxifylline, and baby aspirin, failed to produce significant pain reduction. Radiographs showed fingertip calcium deposits consistent with calcinosis cutis.
Figure appears in full text version.
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Figure 1. Clinical photographs of our subject patient. A, Painful keratotic plaque on the tip of the left hand’s third finger. B, Calcium in the deep dermis exposed after removal of the callus. C, Healed wound after 4 . . . [Full Text of this Article]
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