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Calcinosis cutis in Adult
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Calcinosis cutis in Adult

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Contributors: Christine S. Ahn MD, FAAD, Belinda Tan MD, PhD, William W. Huang MD, MPH, FAAD, Susan Burgin MD
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Synopsis

Calcinosis cutis, or cutaneous calcification, is the deposition of insoluble calcium salts in the skin. Disorders of calcium deposition can be broadly categorized into 5 main subtypes: dystrophic, metastatic, mixed, idiopathic, and iatrogenic. Calcinosis cutis can be viewed as dystrophic when deposits occur in previously damaged skin in the absence of abnormal serum calcium and phosphorus levels and metastatic when deposits occur in the setting of systemic metabolic disorders with calcium and/or phosphorus imbalance. The mixed type refers to the presence of both dystrophic and metastatic factors.

The most common clinical presentation is that of painful, irregularly surfaced nodules. In addition, extrusion of chalk-like substance from calcified nodules and secondary infection can cause pain and significant morbidity.

Dystrophic calcinosis cutis in adults is often seen in autoimmune connective tissue diseases, especially in the CREST form of systemic sclerosis, juvenile dermatomyositis, and occasionally in adult dermatomyositis (10%-20%). Less often, it can be seen in acute systemic, subacute cutaneous, and chronic cutaneous lupus erythematosus, lupus panniculitis, and generalized morphea.

The term "calcinosis universalis" has been used to describe extensive areas of cutaneous calcification with sheet-like masses of calcium deposition.

The most common cause of metastatic calcinosis cutis is advanced renal disease. Calciphylaxis, a mixed type of calcification, is the most dramatic calcification disorder that is seen primarily in chronic renal failure patients and presents as large, painful, well-demarcated violaceous plaques that evolve into necrosis. This disorder is associated with significant morbidity and mortality in this patient population.

Calcinosis cutis may occur at any age, but the increased prevalence of associated disease in the elderly population places this group at heightened risk.

Codes

ICD10CM:
L94.2 – Calcinosis cutis

SNOMEDCT:
21323007 – Calcinosis cutis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 01/11/2018
Last Updated: 01/26/2018
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Calcinosis cutis in Adult
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Calcinosis cutis : Subcutaneous nodules
Clinical image of Calcinosis cutis
Yellow and white small plaques with irregular surfaces on the palm.
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