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February 2009

Surgical Debridement of Painful Fingertip Calcinosis Cutis in CREST Syndrome

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Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Dermatol. 2009;145(2):212-213. doi:10.1001/archderm.145.2.212-b

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.

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.

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