A 61-year-old Caucasian man presented with widespread soft tissue calcinosis. Juvenile dermatomyositis (JDM) had been diagnosed at the age of 12 years, and was treated at the time with high dose corticosteroid. His myositis had been in remission since the age of 16 years, with no new muscle weakness and a normal creatine kinase concentration. However, he had continued to experience regular painful outbreaks of calcinosis lesions over his limbs and torso which caused significant disability—specifically, elbow contractures and infected lesions on his buttocks. On examination the patient had widespread calcinosis affecting superficial and fascial tissues, confirmed radiologically (figures 1 and 2). He had new lesions actively discharging a white chalky …