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Introduction PM-Scl Overlap Systemic Sclerosis (SSc) is an autoimmune disease with varied manifestations and its presentation with calcinosis is very heterogenous in the extent and intensity as well as the inherent complications. Treatment remains investigative and exploratory to date.Material and Methods We present the case of a 57yr man with Scleroderma overlap diagnosed in 2016.His clinical, laboratory features and salient investigations are as in table 1a&1b.Various medications trialed are represented in table 2.His main symptom was discomfort due to tumorous calcinosis in buttocks and posterior thighs. Largest being 2cm diameter.Results In December 2024 he developed infected calcinosis over his buttock ( figure 1) and required admission, IV antibiotics, surgical drainage as well as excision of 2 large tumorous calcinosis. There after district nurses’ input for dressings.He has healed well from the wounds, but rest of the calcinosis remains an issue.Conclusions The precise aetiopathogenesis of calcinosis is still unknown. It presents a therapeutic challenge like in our patient despite various medications trialed. He, however, he healed well post-surgical drainage and the excision of culprit calcinosis.Abstract P.344 Figure 1Multiple tumorous calcinosis buttock (1a) and left chest wall (1b)Abstract P.344 Table 1Abstract P.344 Table 2Various medications trialed