Thoracic Calcinosis Cutis in a Case of Dermatomyositis

A 42-year-old man presented at the outpatient department with a two-month history of cough accompanied by mucoid expectoration, as well as a gradual onset of breathlessness rated at Modified Medical Research Council (MMRC) Grade 1 to 2 over the past five years, progressing to Grade 3 in the last two months. Additionally, he reported intermittent joint pain, loss of appetite, and a progressive weight loss of approximately 20 kilograms over the course of five years. The cough tended to worsen in the mornings but improved throughout the rest of the day. He experienced stiffness in the small joints of his hands, which persisted throughout the day. He also mentioned a previous occurrence of maculopapular rash, a month earlier to the onset of respiratory symptoms, on his hands and face, although no lesions were currently present. Despite seeking treatment in the past including irregular use of both allopathic and ayurvedic medicines, his symptoms had not been alleviated. He denied any seasonal variation in symptoms, allergies, comorbidities, or past known diseases and reported being a non-smoker. Upon examination, the patient was found to be underweight with a Body Mass Index (BMI) of 17 kg/m2. Vital signs were within normal limits, with a pulse rate of 82/min, blood pressure of 130/80 mmHg, respiratory rate of 22 breaths/min, and oxygen saturation of 94% on room air. Auscultation revealed bilateral crackles in the infrascapular, infra-axillary, and mammary areas. No other significant abnormalities were noted.