Bone resorption caused by systemic sclerosis

Hanlin Yin, Liangjing Lu This woman in her 60s presented with a history of a progressively receding chin over several years (fig 1). She also had a 15 year history of diffuse cutaneous systemic sclerosis. On examination, her nose appeared pinched and she had circumoral furrows, thin lips, microstomia, and a retracted chin. Facial computed tomography showed calcium deposits in the soft tissue surrounding the temporomandibular joint and bone resorption of the mandible. Bone resorption is thought to occur in systemic sclerosis as a result of tissue ischaemia; typically the fingers are affected.1 2 Mandibular resorption can occur in 8% of patients with systemic sclerosis and is usually asymptomatic.3 In severe cases, surgical reconstruction can correct facial structural anomalies.