Volume 2, Issue 2, Pages (March 2016)

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Volume 2, Issue 2, Pages 164-167 (March 2016) Leg ulcers in systemic lupus erythematosus associated with underlying dystrophic calcinosis and bone infarcts in the absence of antiphospholipid antibodies  Margo Lederhandler, MD, Whitney Valins, MD, Zena Zoghbi, MD, Marc E. Grossman, MD, FACP  JAAD Case Reports  Volume 2, Issue 2, Pages 164-167 (March 2016) DOI: 10.1016/j.jdcr.2016.02.009 Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Clinical presentation of ulcer. A, 10- × 6-cm irregularly shaped deep ulceration with a granulating base and spicules of calcium on the left medial calf partially overlying the shin and a 4- × 4-cm round ulcer with a fibrinous base above the left medial malleolus. B, Spicules of yellow-white chalky material—calcium—extruding from ulceration. JAAD Case Reports 2016 2, 164-167DOI: (10.1016/j.jdcr.2016.02.009) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Radiograph of left leg shows multiple discrete, irregular areas of calcification in the soft tissue. JAAD Case Reports 2016 2, 164-167DOI: (10.1016/j.jdcr.2016.02.009) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Coronal T1 MRI of lower extremities shows a curvilinear margin of low signal in the left distal tibia, consistent with bone infarction. JAAD Case Reports 2016 2, 164-167DOI: (10.1016/j.jdcr.2016.02.009) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Ulcer with calcium deposits in hematoxylin-eosin stain (A) and von Kossa stain (B) highlighting calcium. (Original magnification: ×4.) JAAD Case Reports 2016 2, 164-167DOI: (10.1016/j.jdcr.2016.02.009) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions