Treatment of calcinosis universalis with aluminium hydroxide.

This male child was born in February 1958. In early infancy he had an operation of the left kidney, but otherwise he was well until the age of 31 years when he developed a skin rash and muscle contractures. Dermatomyositis was diagnosed, and the result of a muscle biopsy was as follows. 'The muscle shows areas of oedema, a patchy but diffuse inflammatory cell infiltrate composed of lymphocytes, large mononuclears, some segmented neutrophils, an occasional eosinophil, and some plasma cells. Muscle fibres appear to be completely gone, with collapse of the sarcolemmal sheath, and in many areas there is a light to dark blue change in staining reaction of the muscle fibre. Other fibres still contain pink-staining material but have completely lost striations.' Extensive ectopic calcification with ulceration through the skin developed over the next 5 years. 2 years before admission he had deteriorated sufficiently to become chair-bound, but there had been little progression immediately before he was seen. In June 1965, he was treated with corticosteroids, but these were discontinued shortly afterwards because of cellulitis ofthe right arm. In January 1967, at the age of nearly 9 years he was admitted to The Royal National Orthopaedic Hospital. Examination showed a pale child, small for his age. There was extensive muscle wasting, with contractures and subcutaneous tissue calcification resulting in ulceration. Movement of all joints was restricted (Table I).