Soft tissue calcinosis complicated by leg ulcers in patient with rheumatoid arthritis : e-poster

Abstract

Background: the cause of leg ulcers in patients with rheumatoid arthritis was found to be multifactorial, with vasculitis and venous insufficiency as the main determinants. Calcinosis is one of the rare determinants of ulceration. The management of such ulcers is correspondingly complex and challenging for medical staff. Case summary: a 67-year-old woman presented with multiple full-thickness infected, painful with fibrin deposits and focal necrosis chronic ulcers of the both calves approximately 6 months in duration. Patient history revealed rheumatoid arthritis with subsequent development of skin induration, vasculitis, calcinosis. X-ray of her lower extremities showed vascular calcification of medium-size blood vessels and osteoporosis. Patient´s medications have included Penthoxyphilin, Diclofenac, Ketoprofen, Gentamicin, Ceftazidim. Her arthritis was controlled on Prednisolone 5mg qd. Skin grafting was performed after the wound infection was healed. Conclusions: Ulcers are generally the result of poor blood supply; arterial vessel walls are the predominant site for ectopic calcification; the calcium deposits in the subcutaneous tissues can lead secondarily to skin ulceration complicated by inflamation and infection.