Template:Short description Template:Infobox medical condition (new) Calcinosis cutis is an uncommon condition marked by calcium buildup in the skin and subcutaneous tissues. Calcinosis cutis can range in intensity from little nodules in one area of the body to huge, crippling lesions affecting a vast portion of the body.<ref name="connective tissue disease">Template:Cite journal</ref> Five kinds of the condition are typically distinguished: calciphylaxis, idiopathic calcification, iatrogenic calcification, dystrophic calcification, and metastatic calcification.<ref name="Reiter 2011">Template:Cite journal</ref>
Tumors, inflammation, varicose veins, infections, connective tissue disease, hyperphosphatemia, and hypercalcemia can all lead to calcinosis. Systemic sclerosis is linked to calcineuris cutis.<ref name="StatPearls">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Calcinosis is seen in Limited Cutaneous Systemic Sclerosis, also known as CREST syndrome (the "C" in CREST).<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
Signs and symptomsEdit
Lesions might be more severe and widespread, or they can develop gradually and show no symptoms. The nodules may cause pain and hinder function in addition to having a variety of sizes and shapes. The underlying condition determines the localization of the lesions in dystrophic calcification. The elbows, fingers, knees, and forearms are the most often affected regions in people with systemic sclerosis. Elbows, knees, and regions of prior inflammatory lesions in dermatomyositis are affected by calcification. Lupus erythematosus affects the limbs, buttocks, area beneath lupus lesions, and periarticular areas. Periarticular lesions are found in metastatic calcification. In tumoral calcinosis, the lesions are found around joints, but in idiopathic calcification, the lesions are found on children's faces as subepidermal calcified nodules. In iatrogenic calcification, the calcification is found at venipuncture sites.<ref name="StatPearls"/>
CausesEdit
Calcinosis may result from a variety of causes such as:<ref name="StatPearls"/>
- Trauma to the region
- Inflammation (bug bites, acne)
- Varicose veins
- Infections
- Tumors (malignant or benign)
- Diseases of connective tissue
- Hypercalcemia
- Hyperphosphatemia
Calcinosis cutis is associated with systemic sclerosis.<ref name="StatPearls"/>
DiagnosisEdit
ClassificationEdit
Calcinosis cutis may be divided into the following types:<ref name="Andrews">Template:Cite book</ref>Template:Rp
Dystrophic calcinosis cutisEdit
Dystrophic calcinosis cutis is the most prevalent kind of calcification on the skin.<ref name="Reiter 2011" /> The ectopic calcified mass usually consists of amorphous calcium phosphate and hydroxyapatite.<ref name="Juvenile Dermatomyositis">Template:Cite journal</ref> Dystrophic calcification is linked to a number of illnesses, such as infections, hereditary diseases, cutaneous neoplasms, and connective tissue diseases.<ref name="Calcifying disorders">Template:Cite journal</ref> The clinical manifestation can be as minor as an accidental radiography imaging finding or as severe as subcutaneous nodules or plaques.<ref name="Calcinosis in Rheumatic Diseases">Template:Cite journal</ref>
Metastatic calcinosis cutisEdit
Metastatic calcinosis cutis is the consequence of calcium salts precipitating in normal tissue due to an underlying abnormality in the metabolism of phosphate and/or calcium.<ref name="Reiter 2011" /> Metastatic calcification can result from any systemic condition raising serum calcium and/or phosphate levels. Chronic renal failure is the most frequent underlying cause.<ref name="UpToDate">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>
Iatrogenic calcinosis cutisEdit
Iatrogenic calcinosis cutis is characterized by firm nodules in the subcutis or dermis, which are caused by calcium salts precipitating quickly in the skin.<ref name="UpToDate"/> This occurrence typically manifests as a warm, sensitive swelling at the site of venipuncture,<ref name="Reiter 2011" /> and it most frequently happens following the extravasation of intravenous calcium chloride, calcium gluconate, or phosphate-containing solutions.<ref name="Tumoral calcinosis of the hand">Template:Cite journal</ref> Iatrogenic calcification, which manifests as soft yellow-white epidermal plaques,<ref name="Reiter 2011" /> has also been linked to calcium salt exposure via electroencephalography or electromyographic electrode compounds.<ref name="Cutaneous deposition diseases">Template:Cite journal</ref>
Traumatic calcinosis cutisEdit
Traumatic calcinosis cutis is a cutaneous condition characterized by calcification of the skin resulting from the deposition of calcium and phosphorus often resulting from occupational exposure, as in cases reported in oil-field workers and coal miners.<ref name="Andrews2">Template:Cite book</ref>Template:Rp
Idiopathic calcinosis cutisEdit
Skin calcification that is not linked to a systemic illness or an underlying tissue injury is referred to as idiopathic calcification.<ref name="Reiter 2011" /> Most often, the calcification is restricted to a single general location, yet there has been one case of calcinosis cutis that is exceptionally broad.<ref name="Guermazi Grigoryan Cordoliani Kérob 2006 pp. 268–270">Template:Cite journal</ref>
Idiopathic scrotal calcinosisEdit
Idiopathic scrotal calcinosis is a cutaneous condition characterized by calcification of the skin resulting from the deposition of calcium and phosphorus occurring on the scrotum.<ref name="Andrews3">Template:Cite book</ref>Template:Rp However, the levels of calcium and phosphate in the blood are normal.<ref name=NEJM_image>Template:Cite journal</ref> Idiopathic scrotal calcinosis typically affects young males, with an onset between adolescence and early adulthood.<ref name=NEJM_image /> The scrotal calcinosis appears, without any symptoms, as yellowish nodules that range in size from 1 mm to several centimeters.<ref name=Khallouk>Template:Cite journal</ref>
Subepidermal calcified noduleEdit
Subepidermal calcified nodule is characterized by calcification of the skin resulting from the deposition of calcium and phosphorus, occurring most frequently as one or a few skin lesions on the scalp or face of children.<ref name="Andrews4">Template:Cite book</ref>Template:Rp
Tumoral calcinosisEdit
Tumoral calcinosis is distinguished by the accumulation of calcific masses surrounding the main joints. It mainly affects teens who are otherwise in good health. Joint function may be hampered by the subcutaneous or intramuscular calcified deposits.<ref name="Reiter 2011" />
Osteoma cutisEdit
Osteoma cutis is a cutaneous condition characterized by the presence of bone within the skin in the absence of a preexisting or associated lesion.<ref name="Andrews5">Template:Cite book</ref>Template:Rp Osteoma cutis often manifests as solid, varying-sized, skin-colored subcutaneous nodules.<ref name="Similar but Different">Template:Cite journal</ref>
TreatmentEdit
Diltiazem, a calcium channel blocker, has been a mainstay of medical treatment for calcinosis cutis.<ref name="connective tissue disease" /> It is thought to work by modifying intracellular calcium levels, which reduces the capacity for the production and crystallization of calcium nidus.<ref name="Torralba Li-Yu Navarra 1999 pp. 74–78">Template:Cite journal</ref>
Colchicine is an antimicrotubule drug with anti-inflammatory properties that has been used for gouty arthritis treatment for a long time.<ref name="connective tissue disease" /> Calcinosis cutis inflammation brought on by a foreign body-like response aggravates the illness's symptoms.<ref name="Colchicine">Template:Cite journal</ref> Colchicine, therefore, has been used to treat calcinosis cutis, albeit with varying degrees of success.<ref name="connective tissue disease" />
GalleryEdit
- Calcinosis cutis dog.jpg
Calcinosis cutis in a dog with Cushing's syndrome
- Calcinosis cutis.jpg
Histopathology of calcinosis cutis in human tissue
See alsoEdit
ReferencesEdit
Further readingEdit
External linksEdit
Template:Localized connective tissue diseases Template:Electrolyte abnormalities