CALCINOSIS CUTIS

Course overview

CALCINOSIS CUTIS OCCURS WHEN CALCIUM SALTS ARE DEPOSITED INTO THE SKIN AND SUBCUTANEOUS TISSUE. IT IS CLASSIFIED INTO FIVE MAIN TYPES: DYSTROPHIC, METASTATIC, IDIOPATHIC, IATROGENIC, AND CALCIPHYLAXIS. DYSTROPHIC CALCIFICATION IS THE MOST COMMON CAUSE OF CALCINOSIS CUTIS AND IS ASSOCIATED WITH NORMAL CALCIUM AND PHOSPHORUS LEVELS. DYSTROPHIC CALCIFICATION IS TYPICALLY ASSOCIATED WITH A SYSTEMIC DISEASE SUCH AS SYSTEMIC SCLEROSIS, DERMATOMYOSITIS, MIXED CONNECTIVE TISSUE DISEASE, OR LUPUS, THAT INDUCES TISSUE DAMAGE AND CREATES A NIDUS FOR CALCIFICATION. METASTATIC CALCIFICATION IS ASSOCIATED WITH ABNORMAL SERUM CALCIUM AND PHOSPHORUS LEVELS, AND DEPOSITION OCCURS WHEN CALCIUM PHOSPHATE PRODUCTION EXCEEDS A CERTAIN VALUE. IDIOPATHIC CALCIFICATION DOES NOT INVOLVE UNDERLYING TISSUE DAMAGE OR ABNORMAL LABORATORY VALUES AND INCLUDES TUMORAL CALCINOSIS, SUBEPIDERMAL CALCIFIED NODULES, AND SCROTAL CALCINOSIS. IATROGENIC CALCIFICATION IS CAUSED BY ADMINISTRATION OF CALCIUM OR PHOSPHATE CONTAINING AGENTS THAT INDUCE PRECIPITATION OF CALCIUM SALTS. CALCIPHYLAXIS INVOLVES CALCIFICATION OF SMALL AND MEDIUM-SIZED VESSELS AND IS ASSOCIATED WITH CHRONIC RENAL FAILURE AND DIALYSIS. THE DISORDER IS CLASSIFIED AS CALCINOSIS CIRCUMSCRIPTA IF IT IS LIMITED TO AN EXTREMITY OR JOINT. CALCINOSIS UNIVERSALIS OCCURS WHEN THERE IS DIFFUSE INVOLVEMENT OF SUBCUTANEOUS AND FIBROUS STRUCTURES OF MUSCLES AND TENDONS. THIS ACTIVITY REVIEWS THE EVALUATION AND MANAGEMENT OF CALCINOSIS CUTIS AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN IMPROVING CARE FOR AFFECTED PATIENTS.