Calcinosis cutis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Calcinosis cutis
Calcinosis cutis under low magnification
Synonyms	Cutaneous calcification
Pronounce	N/A
Specialty	N/A
Symptoms	Hard, white or yellowish nodules on the skin
Complications	Ulceration, infection
Onset	Varies depending on underlying cause
Duration	Chronic
Types	N/A
Causes	Hypercalcemia, chronic kidney disease, autoimmune disorders
Risks	Scleroderma, dermatomyositis, lupus
Diagnosis	Skin biopsy, imaging studies
Differential diagnosis	Gout, pseudogout, lipoma
Prevention	N/A
Treatment	Surgical excision, medications
Medication	Diltiazem, warfarin, bisphosphonates
Prognosis	N/A
Frequency	Rare
Deaths	N/A

Calcinosis Cutis

Calcinosis cutis

Calcinosis cutis is a condition characterized by the deposition of insoluble calcium salts in the skin and subcutaneous tissue. This condition can occur in various forms and is often associated with underlying systemic diseases.

Classification

Calcinosis cutis is classified into several types based on the underlying cause:

Dystrophic Calcinosis

Dystrophic calcinosis occurs in the presence of normal serum calcium and phosphate levels. It is often associated with damaged or necrotic tissue. Common causes include connective tissue diseases such as systemic sclerosis, dermatomyositis, and lupus erythematosus.

Metastatic Calcinosis

Metastatic calcinosis results from elevated serum calcium or phosphate levels, leading to calcium deposition in normal tissues. This type is often seen in conditions such as hyperparathyroidism, chronic kidney disease, and sarcoidosis.

Idiopathic Calcinosis

Idiopathic calcinosis occurs without any identifiable underlying metabolic disorder. It is often localized and can occur in otherwise healthy individuals.

Iatrogenic Calcinosis

Iatrogenic calcinosis is caused by medical interventions, such as the extravasation of calcium-containing solutions during intravenous therapy.

Pathophysiology

The pathophysiology of calcinosis cutis involves the deposition of calcium salts, primarily calcium phosphate, in the skin. This can occur due to local tissue damage, abnormal calcium metabolism, or a combination of both. The deposited calcium can form nodules, plaques, or even large masses, leading to skin ulceration and secondary infection.

Clinical Presentation

Patients with calcinosis cutis may present with firm, whitish nodules or plaques on the skin. These lesions are often asymptomatic but can become painful if they ulcerate or become infected. The distribution of lesions varies depending on the underlying cause, with common sites including the extremities, joints, and buttocks.

Calcinosis cutis under low magnification

Diagnosis

The diagnosis of calcinosis cutis is primarily clinical, supported by histopathological examination of skin biopsies. Imaging studies such as X-rays or CT scans can help assess the extent of calcification. Laboratory tests may be conducted to evaluate serum calcium and phosphate levels, especially in cases suspected of metastatic calcinosis.

Treatment

Treatment of calcinosis cutis focuses on managing the underlying cause and alleviating symptoms. Options include:

• Medical Therapy: Medications such as diltiazem, warfarin, and bisphosphonates may be used to reduce calcium deposition.
• Surgical Intervention: Surgical removal of calcified nodules may be necessary in severe cases.
• Lifestyle Modifications: Patients are advised to avoid trauma to affected areas and maintain good skin hygiene.

Calcinosis Cutis in Animals

Calcinosis cutis in a dog

Calcinosis cutis can also occur in animals, particularly in dogs. It is often associated with Cushing's syndrome or prolonged use of corticosteroids. The clinical presentation in animals is similar to that in humans, with firm, calcified nodules on the skin.

See also

• Calcium metabolism
• Connective tissue disease
• Hypercalcemia
• Skin biopsy