The following is the summary of “Early Abnormal Nailfold Capillary Changes Are Predictive of Calcinosis Development in Juvenile Dermatomyositis” published in the November 2022 issue of Rheumatology by Nozawa, et al.

In recent years, there has been an improvement in the long-term results of juvenile dermatomyositis (JDM). However, calcinosis remains a dangerous consequence that can severely impede function. The causes and predisposing factors of calcinosis are poorly understood. The purpose of this research is to identify potential causes of calcinosis in JDM.

It was a retrospective cohort research conducted at a single site. Since its inception on January 1, 1989, The Hospital for Sick Children’s interdisciplinary JDM clinic has been responsible for the diagnosis and ongoing care of all JDM patients through May 31, 2018. Researchers used Cox regression analysis to look for risk factors associated with the development of calcinosis. The median age at diagnosis was 7.7 years (IQR 4.9-12.1) for the 172 individuals who satisfied inclusion criteria, and the median follow-up was 8.5 years (IQR 3.4-12.6, range 0.1-28.3). 

In univariate analysis, nailfold irregularity at baseline was the sole significant risk factor for the development of calcinosis (hazard ratio [HR] 4.86, P=0.03). The presence of nailfold abnormalities was the sole statistically significant risk factor for calcinosis in multivariable analysis (HR 4.98, P=0.03), including age, sex, and time from onset to diagnosis. In addition, calcinosis was substantially more common in patients who had a chronic course (chi-square 25.8, P<0.001). In children with idiopathic inflammatory myopathies, the presence of aberrant nailfold capillary alterations at baseline is predictive of the development of calcinosis.