Calcinosis Cutis: Causes, Symptoms, Treatment, Diagnosis

Calcinosis Cutis is a pathological condition characterized by deposition of calcium in the skin. The deposition of calcium may not be just restricted to the skin surface but may go deeper down into the tissues as well and even potentially further down to include muscles and various organs of the body.

Although Calcinosis Cutis is not serious a medical condition, but when there are abnormal calcium deposits in the tissues then that is a warning sign because it may cause functional disabilities and may even become life threatening if not treated in the long run. Calcinosis Cutis tends to cause severe pain on the surface of the skin, deformities, and development of skin ulcers. In very rare cases, Calcinosis Cutis can cause gangrene due to blockage of blood flow. Calcinosis Cutis is quite a rare condition and affects both males and females equally.

There are four typos of Calcinosis Cutis. These four types are:

• Dystrophic Calcinosis Cutis:
• Metastatic Calcinosis Cutis
• Idiopathic Calcinosis Cutis
• Iatrogenic Calcinosis Cutis

Dystrophic Calcinosis Cutis: This type of Calcinosis Cutis occurs in areas where the tissue is damaged and is caused by any type of inflammation, malignancy, or tissue necrosis. This is the most common form of Calcinosis Cutis.

Metastatic Calcinosis Cutis: This type of Calcinosis Cutis occurs when there are abnormally high levels of calcium and phosphate in the body.

Idiopathic Calcinosis Cutis: This type of Calcinosis Cutis occurs due to an unknown cause or the cause of which has not been identified. Even the calcium and phosphate levels in the body are normal.

Iatrogenic Calcinosis Cutis: This type of Calcinosis Cutis occurs as a result of using certain medications or as a result of undergoing a surgical procedure and tends to resolve when the medication is stopped and the individual has completely healed from the surgical procedure.

The cause of Calcinosis Cutis depends on the type of Calcinosis Cutis that the individual has.

Cause of Dystrophic Calcinosis Cutis Includes:

• Acne
• Connective tissue disease
• Skin infections
• Trauma or injury to the skin
• Tumors
• Varicose veins.

Cause of Metastatic Calcinosis Cutis Includes:

• Kidney failure
• Hyperparathyroidism
• Paraneoplastic syndrome
• Sarcoidosis.

For Latrogenic Calcinosis Cutis, calcium and phosphate injection is a potential cause. Idiopathic Calcinosis Cutis does not have a known cause.

The classic presenting feature of Calcinosis Cutis is the presence of visible calcium deposits on the skin which start to grow with time but are relatively asymptomatic, although there may be symptoms of the underlying cause of Calcinosis Cutis. These deposits appear as white pimples which gradually start to harden up to form a mass. This mass is tender to palpation and can sometimes cause pain.

As the disease progresses, there is development of skin ulcerations which are quite painful and tender to touch. These ulcers with time start to ooze out discharge. If the deposits are near the joints or the extremities, it becomes difficult to use the affected extremity. In extremely rare instances, there is development of gangrene.

If Calcinosis Cutis is suspected, there will be laboratory tests performed to look for elevated calcium and phosphate levels or other metabolic abnormalities. Radiological studies may be performed to look at the extent to which there are calcium deposits and whether there is any tissue damage or necrosis. A biopsy of the nodule virtually confirms the diagnosis of Calcinosis Cutis.

The treatment of Calcinosis Cutis depends on the underlying cause of the condition. Once the underlying cause and the type of Calcinosis Cutis is identified, then the treating physician formulates a detailed treatment plan which may be multidisciplinary for adequate treatment of the condition. The treatment starts off with a conservative approach with medications. Some of the medications that are given to treat Calcinosis Cutis are corticosteroids, colchicine, diphosphonates, and diltiazem.

A surgical removal of the nodules is done only when the nodules become extremely painful, there is development of ulcers, or if there is any functional impairment caused due to Calcinosis Cutis.

Since a surgical procedure may potentially further aggravate the condition, it is reserved as a last resort. It is very common for Calcinosis Cutis to recur after excision.

As stated, depending on the underlying cause and the type of Calcinosis Cutis, a multidisciplinary team will be working on the patient to treat successfully with little risk for recurrence of Calcinosis Cutis.

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