Calcinosis cutis


Characterized by deposition of calcium in the subcutaneous tissues.

Characterized by multiloculated calcium salt deposits in periarticular soft tissues.

Typically occurs in large joints such as the hip, elbow, shoulder, ankle, and wrist forming on the extensor surface of a joint or on the bursa.

Primary calcinosis, is a familiar condition with variable genetic subtypes.

Primary calcinosis is classified into hyperphosphatemic and normal phosphatemic types.

Secondary calcinosis is frequently associated with chronic renal failure and hyperparathyroidism.

Seen in systemic sclerosis typically at sites of recurrent microtrauma including the distal phalanges, feet, elbows, and forearms.

Calcifications maybe localized or widespread.

Lesions may ulcerates or become infected.

Seen in as many as 25% of patients with systemic sclerosis.

Higher prevalence in patients with positive for anticentromere antibodies.

Classified into four subtypes: metastatic, associated with chronic renal failure, hypervitaminosis D neoplasms; dystrophic seen in collagen vascular diseases, Ehlers-Danlos syndrome, pseudoxanthoma elasticum pancreatic disease; Idiopathic and seen in the scrotum, vulva, penis, and breast and ; iatrogenic.

Metastatic calcifications involving the soft tissues may be related to elevations of the serum calcium- phosphorus product, especially when the result level is more than 70 mg/dL.

Dystrophic calcifications occur in the presence of normal calcium and phosphorus levels and are attributed to increase pH in damaged or devitalized tissue.

The dystrophic calcifications seen in scleroderma may occur in both the limited and systemic disease forms.

Calcinosis in scleroderma is related to the ab2242ant tissue architecture with chronic tissue damage or collagen synthesis with normal serum calcium and phosphate levels.

Diagnosis depends on findings from radiography, CT, and or an MRI.

X-ray findings include: amorphous, cystic, and lobulated calcifications of affected areas.

CT scan may reveal the sedimentation sign, illustrated by layered calcium deposits along with fluid-fluid levels.

T1-weighted MRI usually demonstrates inhomogeneous low signal intensity.

No standard therapy is available.

Treatment focused on the management of underlying abnormalities, such is serum calcium or phosphate imbalances and hyperparathyroidism.

Parathyroidectomy or renal transplantation may lead to the resolution in some patients.

Medical therapies include warfarin, bisphosphonates, minocycline, colchicine, and corticosteroid injections, but the results are equivocal.

Surgical therapy may be required.

Surgery is usually combined with phosphate deprivation and administration of acetaazolamide for long-term control.

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