Calcinosis cutis

Synonym(s)

Cutaneous calcinosis; cutaneous calculi Definition

A group of disorders in which calcium salts, consisting primarily of hydroxyapatite crystals or amorphous calcium phosphate, are deposited in the skin

Pathogenesis

Unclear; involves both metabolic and physical factors; in the setting of hypercalcemia and/or hyperphosphatemia, calcium deposition occurring without preceding tissue damage; damaged tissue possibly allows an influx of calcium ions, leading to calcium precipitation

Clinical manifestation

Multiple, asymptomatic, firm, whitish papules, plaques, or nodules in the dermis and/or subcutis; sometimes spontaneously ulcerating and extruding a chalky white material; dystrophic calcinosis cutis: deposits at the site of trauma; metastatic calcification: widespread calcinosis, often around large joints; common in children with der-matomyositis and in those with CREST syndrome

Differential diagnosis

Gouty tophus; granuloma annulare; xanthoma; foreign body granuloma; milium; osteoma cutis

Therapy

Surgical excision; sodium etidronate and diphosphonates; colchicine; warfarin; int-ralesional triamcinolone 3-4 mg per ml

References

Rodriguez-Cano L, Garcia-Patos V, Creus M. Bastida P, Ortega JJ, Castells A (1996) Childhood calcinosis cutis. Pediatric Dermatology 13(2)1114-117

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