LAUSR

Calcinosis cutis can be divided into 4 major subtypes: dystrophic, metastatic, idiopathic, and iatrogenic. The most common type is dystrophic, which is typically associated with a systemic inflammatory disease such as systemic sclerosis, dermatomyositis, mixed connective tissue disease or lupus, where tissue damage acts as a nidus for calcification. Reported treatment options include sodium thiosulfate, intralesional corticosteroids, diltiazem, warfarin, bisphosphonates, minocycline, ceftriaxone, aluminum chloride, probenecid, colchicine, intravenous immunoglobulin, extracorporal shockwave lithotripsy, diode laser, Erbium YAG, picolaser, carbon dioxide (CO2) laser, and surgical management. Of these therapies, continuous-wave CO2 laser therapy has displayed consistent resolution of calcified nodules and improvement in pain, but is rarely used. We present a case of a 50-year-old woman with limited systemic sclerosis with painful, debilitating digital calcinosis cutis, which limited her daily activities. The patient had previously undergone multiple excisions with orthopedic surgery followed by unsuccessful trials of topical sodium thiosulfate and intralesional sodium thiosulfate with dermatology. Over 8 months, she successfully underwent 4 treatments of continuous-wave CO2 laser therapy with curettage for 5 nodules on4 fingerswithout complications. The patient’s hand surgeon was consulted before starting and was available incase complications occurred.