CLINICAL-SIGNIFICANCE OF SUBCUTANEOUS CALCINOSIS IN PATIENTS WITH SYSTEMIC-SCLEROSIS - DOES DILTIAZEM INDUCE ITS REGRESSION

Objective-To establish whether diltiazem reduces subcutaneous calcinos is (SCC) in patients with systemic sclerosis (SSc), and whether this c alcinosis is related to other signs or symptoms. Methods-47 patients w ith SSc were evaluated and divided into two groups according to the pr esence or absence of SCC. Results-Among the 12 patients with SCC who w ere treated with diltiazem and had sequential hand radiographs (differ ential time between the two radiographs: 7.8+/-4 years), there was a s light radiological improvement in three patients only. More patients w ith SCC had anticentromere antibodies than patients without (p=0.003), fewer had anti-Sd 70 antibodies (p=0.01), more had telangiectasia and giant capillaries (p=0.04 and 0.048 respectively), and SCC patients h ad significantly fewer capillaries at the nailfold (p=0.03). Conclusio n-These results do not clearly indicate that diltiazem is effective in calcinosis associated with SSc. Among the patients with SSc, those wh o also had SCC exhibited a distinctive autoimmune profile and more sev ere cutaneous capillary injury than those without SCC.