How do you get calcinosis cutis ?

 CALCINOSIS CUTIS :

Calcinosis cutis  is a type of calcinosis where in calcium deposits form in the skin . A variety of factor can results in this condition . The most common source is dystrophic calification which occurs in soft tissue as a response to injury . In addition  calcinosis is seen in limited cutaneous systemic sclerosis , also known as CREST syndrome . In dogs and is thought to occur after a traumatic injury . 



WHAT ARE THE SIGNS AND SYMPTOMS OF CALCINOSIS CUTIS ?

The signs and symptoms of calcinosis cutis vary according to the underlying cause . In  many cases, the lesions  gradually develop and are often symptomless . The lesions usually appear as firm , whitish /yellowish papules , plaques or nodules on the surface of the skin .  A solitary lesion may develop, although multiple lesions are more common . Lesion may  become tender  and ulcerate , discharging  chalk - like creamy material consisting mainly of calcium phosphate with a small amount of calcium carbonate . Fingertips lwsion may be painful , while lesions at other sites may restrict joint  mobility and limit movement due to stiffening of the skin . In severe casescutaneous gangrene may occur . 



WHAT ARE THE CAUSES OF CALCINOSIS CUTIS ?

Calcinosis cutis is classified into 4 major types :

1. DYSTROPHIC CALCINOSIS CUTIS :

Dystrophic calcinosis cutis occurs in an area where there is damaged , inflamed , neoplastic  or necrotic skin. Tissue damage may be from mechanical, chemical , infectious or other factors . Normal serum calcium and phosphate  levels exist . Conditions that can dystrophic calcinosis cutis may include :

  • trauma 
  • acne 
  • varicose  veins 
  • infections 
  • tumours 
  • connective tissue disease 
  • panniculitis 
  • inherited diseases of connective tissue 
2. METASTATIC CALCINOSIS CUTIS :
Metastatic calcinosis cutis occurs in the setting of abnormal calcium and phosphate metabolism and is often associated with hypercalcaemia and / hyperphosphataemia . 
- primary or secondary hyperparathyroidism 
- paraneoplasic hypercalcaemia 
- destructive bone disease , such as paget disease 
- sarcoidosis 
- chronic renal failure 
- calciphylaxis 

3. IDIOPATHIC CALCINOSIS CUTIS :
Idiopathic calcinosis cutis generally occurs in the absence o fany known tissues injury or systemic metabolic defect . Calcification is usually localised to one general area . 

4. LATROGENIC CALCINOSIS CUTIS :
Latrogenic calcinosis cutis  arises secondary to a treatment or procedure , for example , parenteral administration of calcium or phosphate , and alcium deposition in newborns from repeated heel sticks . 



HOW TO  TREAT CALCINOSIS CUTIS ?

The underlying cause of calcicinosis cutis should be identified and treated accordingly . medical therapy  may be used to help relieve symptoms of the condition but are generally of limited and variable  benefits . Medications that may be tried  include corticosteroids , colchicine , sodium etidronate , diltiazem and magnesium and aluminium antacids . 
Surgical removal of lesions is indicated when they :

  • become very painful 
  • ulcerate and recurrent infections occur 
  • cause functional  impairment 


Surgical trauma may stimulate further calcification , it may be best to excise a small site before going  ahead with a large excision . Recurrence is common after excision . 
Depending on the underlying cause , a multidisciplinary team of physicians including rheumatologist , and  haematologists may be needed to manage the condition . 




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