Metastatic calcinosis cutis

Calcinosis cutis may be associated with metastatic calcification, dystrophic calcification, tumoral calcinosis, or may be deemed idiopathic. The association of cutaneous calcification with metastatic or tumoral calcinosis is quite rare. A case of metastatic calcinosis cutis in a woman with chronic renal failure and secondary hyperparathyroidism is presented. Other causes of calcinosis cutis are discussed briefly.     

Fingertip calcinosis cutis

Calcinosis cutis, a rare disorder caused by an abnormal deposit of calcium phosphate into the skin, is observed in a variety of disorders. Peculiar conditions feature skin calcifications in children and may have an iatrogenic origin. The unusual case of a baby showing periodic transepidermal elimination of calcified nodules from her fingertips is reported. In this case, fingertip calcinosis cutis was probably caused by ischemic damage due to the venous obstruction that occurred during intensive care in the neonatal period.     

Milia-like idiopathic calcinosis cutis

Milia-like idiopathic calcinosis cutis is a rare entity. Only 17 cases have been reported so far. Two-thirds of these have been associated with Down syndrome. We report the fifth case occurring in a child without Down syndrome. Milia-like idiopathic calcinosis cutis has long been regarded as a peculiar subtype of idiopathic calcinosis cutis. The pathogenesis of the disorder remains unclear.     

皮肤钙质沉着症1例

报告1例皮肤钙质沉着症。患者男性，40岁。左侧臀部肌注青霉素后，注射部位陆续出现黄豆大小淡白色丘诊和结节，自行破溃流出白色石灰样物，逐渐形成凹凸不平的硬性斑块33年。组织病理检查示真皮深部组织可见大小不等团状钙化物沉积，呈均质性或钙化球，HE染色呈深蓝色。     

Dystrophic calcinosis cutis in subacute lupus

Dystrophic calcinosis cutis is known to be associated with various connective tissue disorders but to the best of our knowledge has never been reported in subacute cutaneous lupus erythematosus (SCLE), a distinctive cutaneous subset in the spectrum of lupus erythematosus. It occurs without calcium and phosphorus metabolic abnormalities and may be localized or generalized. We report a patient with SCLE who developed calcinosis cutis and had normal serum calcium and phosphorus levels and, interestingly, a normal concentration of blood ionized calcium. This latter, which represents the active form in the total amount of blood calcium, is a parameter only rarely assessed in patients with dystrophic calcinosis cutis. Thus, other pathogenic factors should be investigated to clarify the pathophysiology of the dystrophic type of calcification.     

特发性皮肤软组织钙沉着症一例

临床资料 患儿，男，7岁。主因臀部结节2年、右肘部结节1个月，于2012年7月9日就诊。2年前发现患儿左侧臀部有一黄豆大、坚实小结节，无痛痒，当地医院诊断为“皮脂腺囊肿”，予手术切除。     

Dystrophic calcinosis cutis in pseudoxanthoma elasticum

Pseudoxanthoma elasticum (PXE) is a genetic disorder in which elastic fibers become calcified with prominent cutaneous, ocular, and cardiovascular features. Calcinosis cutis is an acquired disorder of calcium deposition in cutaneous tissues that occurs as one of the following forms: dystrophic, metastatic, idiopathic, and iatrogenic. We report a case of a woman with PXE who developed widespread dystrophic calcinosis cutis in areas affected by PXE. Although tumoral calcification and nephrolithiasis have been reported in patients with PXE, only one other case in the English-language literature of PXE and calcinosis cutis has been reported and this case was characterized by small, milia-like papules on the front of the neck, without significant discomfort, whereas our patient had widespread involvement that was very painful and pruritic. On 6-month follow-up, this patient had only mild improvement after treatment with an anti-itch lotion and aluminum hydroxide, with which she was noncompliant.     

特发性皮肤钙沉着症一例

正临床资料患者,男,15岁。主因左臀部肿物2年,于2015年9月1日就诊。2年前,无明显诱因患者左臀部出现一绿豆大小皮下肿物,无自觉症状,近半年来肿物逐渐增大。既往体健,发病前无局部注射史及外伤感染史,未接受钙剂治疗,家族中无类似疾病患者。体格检查:发育正常,营养中等,无突眼及甲状腺肿大,全身浅表淋巴结未触及增大。心、肺、腹查体均未见明显异常,四肢关节无畸形,肢端无硬化。     

An unusual case of calcinosis cutis

A case of calcinosis cutis is presented in a patient with hypercalcemia of unknown etiology. The axillae and inguinal areas were involved and the clinical and histologic picture is compared with pseudoxanthoma elasticum. We propose that the similarities between the two diseases stem from a common origin in damaged elastic fibers.     

Iatrogenic calcinosis cutis following nadroparin injection

Accumulation of calcium in the skin is usually classified as a group of disorders referred to as calcinosis cutis. We report the case of a patient who developed iatrogenic calcinosis at the site of subcutaneous administration of low-molecular-weight heparins (LMWH) as nadroparin. This is usually used for the prevention of deep venous thrombosis, especially following renal transplantation. The role of calcium content in nadroparin is discussed.     

Congenital calcinosis cutis of the ear

Congenital calcinosis cutis is a relatively rare event. Herein we report 3 cases of congenital calcinosis cutis that all appeared in the exact same location on the ear. A possible mechanism of pathogenesis is discussed.     

Congenital calcinosis cutis of the foot

Calcinosis cutis is a rare disease characterized by deposition of insoluble calcium salts in the skin. Subepidermal calcified nodule is a form of idiopathic calcinosis cutis that commonly affects children but rarely presents at birth. Herein we describe a healthy 10-month-old boy who had a solitary hard nodule on the left foot since birth. Surgical excision of the nodule was done and histopathology confirmed the diagnosis of subepidermal calcified nodule.     

Idiopathic calcinosis cutis of the penis

Calcification of the penis, whether in the skin, subcutaneous tissue or corpora is exceedingly rare and is usually secondary to trauma or Peyronie's disease. A case of idiopathic calcinosis cutis of the penis is presented.     

Diffuse calcinosis cutis in a patient with congenital leukemia and leukemia cutis

We report an unusual case of congenital leukemia with leukemia cutis (LC) and diffuse calcinosis cutis. A newborn girl presented with widespread dusky red and yellowish cutaneous nodules and papules. Bone marrow morphology was consistent with the diagnosis of acute monocytic leukemia of the FAB M5 type. Skin biopsy specimens confirmed the presence of a leukemic infiltrate and revealed calcium salt deposition in the papillary and reticular dermis. Calcinosis was diffuse in the whole skin but spared other organs. Vascular calcification was not present. Serum calcium levels oscillated between 2.5 and 2.86 mmol/l, and phosphorus, parathyroid hormone and 25-hydroxyvitamin D(3) levels were normal. There were diffuse osteoporosis and spontaneous fractures of small tubular bones. The patient responded to chemotherapy but, following consolidation treatment, developed sepsis and died at 120 days of age. Congenital leukemia is rare and LC is uncommon. Hypercalcemia may be a complication of leukemia, which leads to multiorgan metastatic calcification. Despite the absence of frank hypercalcemia, the presence of bone lesions suggests that the patient's calcinosis cutis was of the metastatic type. However, the cutaneous leukemic infiltrate may also represent a triggering factor for calcium deposition in the skin.