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Infected SSc Calcinosis — SCE Rheumatology MCQ

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HardSystemic SclerosisInfected SSc CalcinosisSCE Rheumatology

A systemic-sclerosis calcinosis deposit has ulcerated. There is spreading erythema, purulent discharge and recurrent Staphylococcus aureus despite one short antibiotic course. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Give culture-directed antibiotics and wound care; assess the deposit for excision

Explanation lettering: E = shown as A · A = shown as E

E is correct. Secondary bacterial infection requires culture-directed antimicrobial therapy and meticulous wound care. Persistent or recurrent infection may require specialist debridement or excision of the calcified nidus. A increases immunosuppression during infection. B risks worsening infection. C does not treat calcinosis or infection. D incorrectly assumes purulent ulcers are sterile.

Reference: BSR 2024 guideline for management of systemic sclerosis: https://academic.oup.com/rheumatology/article/63/11/2956/7750184