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September 2017

Intralesional Sodium Thiosulfate Treatment for Calcinosis Cutis in the Setting of Lupus Panniculitis

Author Affiliations
  • 1Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA Dermatol. 2017;153(9):944-945. doi:10.1001/jamadermatol.2017.0966

We report the case of a patient with lupus panniculitis and localized cutaneous calcinosis that was successfully treated with intralesional sodium thiosulfate injections.

A woman in her 40s with a history of systemic lupus erythematosus presented with a 3-year history of tender subcutaneous nodules on her arms, abdomen, and lower extremities. On physical examination, she was found to have multiple depressed plaques and indurated subcutaneous nodules, some with overlying violaceous erythema, dyspigmentation, and atrophic scarring (Figure 1). Tissue culture findings were negative. Biopsy findings revealed marked interstitial dermal mucin deposition, lymphocytic inflammation involving the deep dermis and subcutis with secondary vasculitic changes, fibrinoid degeneration, subcutaneous fat necrosis, and tissue calcification (Figure 2), confirming a clinical diagnosis of lupus panniculitis with localized cutaneous calcinosis.