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DermAtlas: THUMB - CREST syndrome
© 2001-2009, DermAtlas
Image Name: Crest_syndrome_1_090828   File Type: jpg
Diagnosis: CREST SYNDROME /
SCLERODERMA
  Category: lumps & bumps (plaques, nodules, tumors) /
collagen vascular disease
Body Site: thumb / finger   Age: 60 years
Contributor: Nikolaos Sferopoulos, MD    
Description: tender 1 cm nodule with central white chalky papule
Comments: A 60-year-old woman was referred for a painful lesion of the tip of her right thumb. Radiographs indicated diffuse sclerotic lesions in the soft tissues of the distal phalanx of her thumb. She reported an over 15-year-history of Raynaud phenomenon and positive antinuclear antibody titer. The lesion was surgically debrided under local anaesthesia but the borders could not be identified. Biopsy showed localized calcinosis cutis. The patient was referred to rheumatology where the diagnosis of Crest syndrome was made. Two weeks later the sutures were removed, and the scar was ruptured because of residual calcinosis in the soft tissues. By that time the borders of the lesions were easily identified and removed. No residual clinical lesion was evident 2 months post operatively despite radiographic evidence of persistent calcinosis.
Related Images: Crest_syndrome_2_090828 

DermAtlas: THUMB - CREST syndrome
© 2001-2009, DermAtlas
Image Name: Crest_syndrome_2_090828   File Type: jpg
Diagnosis: CREST SYNDROME /
SCLERODERMA
  Category: lumps & bumps (plaques, nodules, tumors) /
collagen vascular disease
Body Site: thumb / finger   Age: 60 years
Contributor: Nikolaos Sferopoulos, MD    
Description: tender 1 cm nodule with central white chalky papule
Comments: A 60-year-old woman was referred for a painful lesion of the tip of her right thumb. Radiographs indicated diffuse sclerotic lesions in the soft tissues of the distal phalanx of her thumb. She reported an over 15-year-history of Raynaud phenomenon and positive antinuclear antibody titer. The lesion was surgically debrided under local anaesthesia but the borders could not be identified. Biopsy showed localized calcinosis cutis. The patient was referred to rheumatology where the diagnosis of Crest syndrome was made. Two weeks later the sutures were removed, and the scar was ruptured because of residual calcinosis in the soft tissues. By that time the borders of the lesions were easily identified and removed. No residual clinical lesion was evident 2 months post operatively despite radiographic evidence of persistent calcinosis.
Related Images: Crest_syndrome_1_090828 

DermAtlas: TRUNK - morphea
© 2001-2009, DermAtlas
Image Name: morphea_5_081026   File Type: jpg
Diagnosis: MORPHEA /
SCLERODERMA
  Category: collagen vascular disease /
atrophy
Body Site: trunk   Age: 6 years
Contributor: Eric Ehrsam, MD    
Description: multiple 2-10 cm circumscribed round to oval hypopigmented indurated plaques with a lilac border and overlying atrophy and fine scale
Comments: A 6-year-old boy was evaluated for multiple circumscribed, indurated plaques surrounded by a zone of violaceous color (lilac ring). They were localized to his back, ombilical area, hip, and abdomen. The diagnosis of morphea (or localized sclerodermi) was confirmed by a biopsy.
Related Images: All related Images  morphea_1_081026  morphea_2_081026  morphea_3_081026  morphea_4_081026 

DermAtlas: TRUNK - morphea
© 2001-2009, DermAtlas
Image Name: morphea_4_081026   File Type: jpg
Diagnosis: MORPHEA /
SCLERODERMA
  Category: collagen vascular disease /
atrophy
Body Site: trunk   Age: 6 years
Contributor: Eric Ehrsam, MD    
Description: multiple 2-10 cm circumscribed round to oval hypopigmented indurated plaques with a lilac border and overlying atrophy and fine scale
Comments: A 6-year-old boy was evaluated for multiple circumscribed, indurated plaques surrounded by a zone of violaceous color (lilac ring). They were localized to his back, ombilical area, hip, and abdomen. The diagnosis of morphea (or localized sclerodermi) was confirmed by a biopsy.
Related Images: All related Images  morphea_1_081026  morphea_2_081026  morphea_3_081026  morphea_5_081026 

DermAtlas: TRUNK - morphea
© 2001-2009, DermAtlas
Image Name: morphea_3_081026   File Type: jpg
Diagnosis: MORPHEA /
SCLERODERMA
  Category: collagen vascular disease /
atrophy
Body Site: trunk   Age: 6 years
Contributor: Eric Ehrsam, MD    
Description: multiple 2-10 cm circumscribed round to oval hypopigmented indurated plaques with a lilac border and overlying atrophy and fine scale
Comments: A 6-year-old boy was evaluated for multiple circumscribed, indurated plaques surrounded by a zone of violaceous color (lilac ring). They were localized to his back, ombilical area, hip, and abdomen. The diagnosis of morphea (or localized sclerodermi) was confirmed by a biopsy.
Related Images: All related Images  morphea_1_081026  morphea_2_081026  morphea_4_081026  morphea_5_081026 

DermAtlas: TRUNK - morphea
© 2001-2009, DermAtlas
Image Name: morphea_2_081026   File Type: jpg
Diagnosis: MORPHEA /
SCLERODERMA
  Category: collagen vascular disease /
atrophy
Body Site: trunk   Age: 6 years
Contributor: Eric Ehrsam, MD    
Description: multiple 2-10 cm circumscribed round to oval hypopigmented indurated plaques with a lilac border and overlying atrophy and fine scale
Comments: A 6-year-old boy was evaluated for multiple circumscribed, indurated plaques surrounded by a zone of violaceous color (lilac ring). They were localized to his back, ombilical area, hip, and abdomen. The diagnosis of morphea (or localized sclerodermi) was confirmed by a biopsy.
Related Images: All related Images  morphea_1_081026  morphea_3_081026  morphea_4_081026  morphea_5_081026 

DermAtlas: TRUNK - morphea
© 2001-2009, DermAtlas
Image Name: morphea_1_081026   File Type: jpg
Diagnosis: MORPHEA /
SCLERODERMA
  Category: collagen vascular disease /
atrophy
Body Site: trunk   Age: 6 years
Contributor: Eric Ehrsam, MD    
Description: multiple 2-10 cm circumscribed round to oval hypopigmented indurated plaques with a lilac border and overlying atrophy and fine scale
Comments: A 6-year-old boy was evaluated for multiple circumscribed, indurated plaques surrounded by a zone of violaceous color (lilac ring). They were localized to his back, ombilical area, hip, and abdomen. The diagnosis of morphea (or localized sclerodermi) was confirmed by a biopsy.
Related Images: All related Images  morphea_2_081026  morphea_3_081026  morphea_4_081026  morphea_5_081026 

DermAtlas: FACE - calcinosis cutis
© 2001-2009, DermAtlas
Image Name: Calcinosis_Cutis_Ulceration_1_061115   File Type: jpg
Diagnosis: CALCINOSIS CUTIS /
SCLERODERMA
  Category: collagen vascular disease /
cutaneous sign of systemic disease
Body Site: face / cheek
cheek
  Age: 48 years
Contributor: António Matos da Fonseca, MD    
Description: Middle-age woman with a history of diffuse scleroderma for more than 15 years. The patient develops lipoatrophy of the face and multiple calcified subepidermal nodules on the left masseteric region and a large ulceration with secondary infection and exposure of a piece of a homogeneous solid calcic substance. A correcting surgery for removal of the nodules and skin plasty was performed. Histopathologic exam demonstrates multiple calcium deposition in the dermis with a surrounding foreign body giant cell reaction.
Comments: This 48-year-old woman with a history of diffuse scleroderma for more than 15 years developed lipoatrophy of the face and multiple calcified subepidermal nodules over the left masseter. A large ulceration subsequently occurred on the left side of the face exposing rock hard chalky material. The nodules were excised and the defect was repaired. Histopathologic exam demonstrated multiple calcium nodules in the dermis with a surrounding foreign body giant cell reaction.

DermAtlas: HAND - calcinosis cutis
© 2001-2009, DermAtlas
Image Name: calcinosis_cutis_1_060522   File Type: jpg
Diagnosis: CALCINOSIS CUTIS /
SCLERODERMA
  Category: collagen vascular disease /
cutaneous sign of systemic disease
Body Site: hand   Age: 62 years
Contributor: Eleni Theodorakopoulou    
Description: multiple tender firm white scaly papules
Comments: This 62-year-old woman with a history of diffuse scleroderma for 8 years developed cutaneous calcifications on her hands. A skin biopsy demonstrated calcium deposition in the dermis with a surrounding foreign body giant cell reaction.
Related Images: All related Images  calcinosis_cutis_3_060522  calcinosis_cutis_2_060522 

DermAtlas: HAND - calcinosis cutis
© 2001-2009, DermAtlas
Image Name: calcinosis_cutis_2_060522   File Type: jpg
Diagnosis: CALCINOSIS CUTIS /
SCLERODERMA
  Category: collagen vascular disease /
cutaneous sign of systemic disease
Body Site: hand   Age: 62 years
Contributor: Eleni Theodorakopoulou    
Description: multiple tender firm white scaly papules
Comments: This 62-year-old woman with a history of diffuse scleroderma for 8 years developed cutaneous calcifications on her hands. A skin biopsy demonstrated calcium deposition in the dermis with a surrounding foreign body giant cell reaction.
Related Images: All related Images  calcinosis_cutis_3_060522  calcinosis_cutis_1_060522 

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© DermAtlas, Johns Hopkins University; 2000-2009
Bernard A. Cohen, MD, Christoph U. Lehmann, MD

DermAtlas was last updated: Oct-28-2009
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