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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le jeudi 28 novembre 2019
Doi : 10.1016/j.jaad.2019.07.006
accepted : 7 July 2019
Treatment of calcinosis cutis in systemic sclerosis and dermatomyositis: A review of the literature
 

Hélène Traineau, MD a, Rohit Aggarwal, MD b, Jean-Benoît Monfort, MD a, Patricia Senet, MD a, Chester V. Oddis, MD b, Carlo Chizzolini, MD, PhD c, d, Annick Barbaud, MD, PhD a, Camille Francès, MD a, Laurent Arnaud, MD, PhD e, François Chasset, MD a,
a Sorbonne Université, Faculté de Médecine Sorbonne Université, Assistance Publique–Hôpitaux de Paris, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France 
b Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 
c Department of Immunology and Allergy, University Hospital and School of Medicine, Geneva, Switzerland 
d Department of Pathology and Immunology, School of Medicine, Geneva, Switzerland 
e Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Laboratoire d'ImmunoRhumatologie Moléculaire, Centre National de Référence des Maladies Systémiques Auto-immunes Rares Est Sud-Ouest, INSERM UMR S1109, Université de Strasbourg, Strasbourg, France 

Reprint requests: François Chasset, MD, Sorbonne Université, AP-HP, Service de Dermatologie et d'Allergologie, Hôpital Tenon, 4 Rue de la Chine 75970 Paris CEDEX 20, France.Sorbonne UniversitéAP-HPService de Dermatologie et d'AllergologieHôpital Tenon4 Rue de la ChineParis CEDEX 2075970France
Abstract
Background

We have limited data on the treatment of calcinosis cutis associated with systemic sclerosis and dermatomyositis.

Objective

To assess the efficacy and tolerance of available treatments for calcinosis cutis based on previously published studies.

Methods

We performed a systematic review of studies published in Medline, Embase, and the Cochrane library during 1980-July 2018. The strength of clinical data was graded according to the modified Oxford Centre for Evidence-Based Medicine levels of evidence.

Results

In all, 30 studies (288 patients) were included. Eleven therapeutic classes, surgery, and physical treatments were identified as potential treatment options for calcinosis cutis. On the basis of results of a small randomized controlled trial and 4 retrospective studies, low-dose warfarin should not be used for calcinosis cutis (level IB evidence). The results of several studies suggest diltiazem and bisphosphonates might be useful treatment options (level IV). Considering biologic therapies, rituximab has shown promising results in treating both dermatomyositis and systemic sclerosis, whereas tumor necrosis factor inhibitors might be useful for treating juvenile dermatomyositis (level IV). Intralesional sodium thiosulfate might be a promising alternative (level IV).

Limitations

Few included studies had a high level of evidence.

Conclusion

This study highlights the efficacy and tolerance profiles of available treatments for calcinosis cutis, with a focus on level of evidence.

The full text of this article is available in PDF format.

Key words : calcinosis cutis, dermatomyositis, level of evidence, systemic sclerosis

Abbreviations used : RCT, SSc, STS



 Funding sources: None.
 Conflicts of interest: Dr Arnaud has received honoraria from Roche-Chugaï, Grifols, LFB, Pfizer, and UCB. Dr Chizzolini has received travel support from Roche-Chugaï. Dr Traineau, Dr Aggarwal, Dr Monfort, Dr Senet, Dr Oddis, Dr Barbaud, Dr Francès, and Dr Chasset have no conflicts of interest to disclose.

  10, 26, 27, 28, 29, 33, 34, 35, 37, 38, 39, 40, 41, 42, 49, 50, 52


© 2019  American Academy of Dermatology, Inc.@@#104156@@
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