Calcinosis cutis: part II. Treatment options

Because calcinosis cutis is a rare syndrome, there is a notable lack of controlled clinical trials on its treatment. The efficacy of calcinosis treatment has only been reported in single cases or small case series. No treatment has been generally accepted as standard therapy, although various treatments have been reported to be beneficial, including warfarin, bisphosphonates, minocycline, ceftriaxone, diltiazem, aluminium hydroxide, probenecid, intralesional corticosteroids, intravenous immunoglobulin, curettage, surgical excision, carbon dioxide laser, and extracorporeal shock wave lithotripsy.     

Calcinosis cutis

A 22-year-old male patient presented with multiple swellings over elbows and knees and a sinus over the right elbow discharging chalky white material. Skin biopsy of the swelling demonstrated calcium deposition in dermis and subcutis. There was no evidence of connective tissue disorder or abnormal mineral metabolism. Hence it was concluded as idiopathic calcinosis cutis and is reported for its interesting presentation.     

Calcinosis cutis universalis

We report the case of a 49-year-old female who complained of hardening of the skin, with onset about 1.5 years before presentation. The laboratory data showed normal biochemistry profile. Routine haematochemical examinations showed slight anaemia, an increased erythrocyte sedimentation rate and negative rheumatological markers. Calcium excretion in a 24-h urine sample was normal, but the phosphate excretion was slightly low. The clinical diagnosis was verified by soft tissue ultrasound examination showing subcutaneous calcifications. X-ray examination of bones evidenced no abnormal calcification. Mammography revealed deep seated bilateral reticular calcifications, even in the axillary region. Histological examination showed calcinosis cutis. On these grounds, the diagnosis of idiopathic universal calcinosis cutis was made. The authors describe the clinical and histological picture and discuss the laboratory findings.     

Calcinosis cutis: critical review

The most widely accepted classification of calcinosis cutis is reviewed and several aspects of it are examined. The main point of our criticism is that entities from different groups overlap. Also, the classification mixes etiopathogenic criteria with morphological or semiologic ones. Moreover, the role of the dermatopathologist is limited many times, since only generic information under the diagnosis "calcinosis cutis" is given to the clinician. Taking these into account, we introduce a possible morphological classification of calcinosis cutis, based on the pattern of the cutaneous deposits.     

皮肤钙质沉着症1例

患者,男,56岁,农民因左面颊皮疹15年,渐增大,至我科就诊。患者15年前无明显诱因左面颊出现一针尖大黑点,不痛不痒,缓慢增长。10年前皮疹增至小米粒大,并由黑色逐渐变为黄白色。5年前皮疹增至绿豆大,稍高出皮面,夏天出汗多时有轻痒。1年前来我科就诊时皮疹面积约20ｃｍ×25ｃｍ,     

Calcinosis cutis following trauma

We report an 8-year-old boy who developed dystrophic calcinosis cutis that occurred following trauma. Multiple abrasions were observed in the inguinal folds after a soccer game. Subsequently, multiple papules with soft centers and white particles appeared in the same area. A biopsy specimen showed calcinosis cutis with transepidermal elimination of calcium. The causes of the underlying tissue damage associated with dystrophic calcinosis are discussed.     

皮肤钙质沉着症及治疗

目的:探讨皮肤钙质沉着症的临床特点及治疗方法.方法:回顾性分析2例皮肤钙质沉着症的临床资料.结果:1例头皮皮肤钙质沉着症为外伤性皮肤钙质沉着症,经皮肤扩张及皮瓣转移修复的手术方法治愈;另1 例为特发性阴囊皮肤钙质沉着症,因局部阴囊皮肤修复难度较大而放弃手术治疗.结论:皮肤钙质沉着症为临床少见病,组织病理活检可确诊,手术治疗是有效可靠的治疗方法,切除范围要足够以免复发,一期皮肤扩张器埋植,二期皮瓣转移修复对头皮病灶效果较满意.     

Chronische Dermatomyositis mit Calcinosis cutis

Ohne Zusammenfassung     

Calcinosis cutis complicating liver transplantation

We report a case of calcinosis cutis in a 41-year-old man developing after liver transplantation at sites where no intravenous calcium had been administered. The cutaneous lesions developed on his right upper arm 10-days post-transplantation. The patient had received calcium chloride solution intravenously after surgery. We excluded other causes of ectopic calcification such as hyperparathyroidism, renal failure, and extravasation of calcium chloride.     

Calcinosis cutis universalis und Poikilodermie

Zusammenfassung Calcinosis cutis universalis und Poikilodermie wurden nebeneinander bei einer bandförmigen Sklerodermie und bei einer Dermatomyositis gesehen. Es handelt sich um atrophische Endzustände bei verschiedenartigen Krankheiten, nicht um selbständige Krankheitseinheiten.     

Calcinosis cutis: a rare feature of adult dermatomyositis

Dermatomyositis is an idiopathic inflammatory myopathy with characteristic cutaneous manifestations. We describe a case of a 55-year-old woman with dermatomyositis who presented with dystrophic calcinosis resistant to medical treatment.     

Calcinosis cutis in autoimmune connective tissue diseases

Calcinosis cutis is a chronic condition involving insoluble calcified deposits of the skin and subcutaneous tissue. It is commonly associated with autoimmune connective tissue diseases and can be a source of pain and functional disability. The likelihood of developing calcinosis varies among the autoimmune connective tissue diseases, with systemic sclerosis and dermatomyositis being the most commonly associated. Identification of therapy for this challenging disorder has been hampered by a paucity of large controlled trials. Although there is no uniformly effective treatment for calcinosis cutis, several surgical and medical therapies have demonstrated varying degrees of benefit in the treatment of calcinosis, including surgical excision, laser therapy, extracorporeal shock wave lithotripsy, diltiazem, minocycline, colchicine, and topical sodium thiosulfate, along with others. Recommendations for the diagnosis and therapy of calcinosis cutis in patients with autoimmune connective tissue diseases are discussed.