Diseases

Calcinosis cutis – Causes, Symptoms & Treatment

Calcinosis of the skin

In the case of calcinosis cutis , calcium phosphate is deposited in the skin. The causes are complex and include, for example, disorders of the calcium metabolism. Treatment consists of surgical removal of the plaque and therapy for its primary cause.

Was ist Calcinosis cutis?

In the so-called calcinosis, calcium salts accumulate in the skin or in the organs in a pathological way and become permanently fixed. In the human body, calcium occurs primarily as a phosphate salt in the sense of hydroxyapatite within the bones, where it ensures the strength of bone tissue and fulfills a reservoir function, i.e. it can be released when needed.

The deposit of calcium salts in individual tissues and organs can, in addition to the accumulation of calcium carbonate, primarily correspond to the storage of calcium phosphate. Calcinosis cutis is a form of calcinosis and manifests itself in the form of calcium phosphate deposits within the skin. The skin of the extremities is usually affected.

The pathological phenomenon is the symptom of an overarching disease and is also known as skin calcinosis. There are different forms of calcinosis cutis:

  • Metastatic calcinosis
  • Metabolic calcinosis in Form einer Calcinosis limited oder universalis,
  • Calcinosis dystrophica
  • Idiopathic calcinosis
  • latrogenic calcinosis.

The subdivision into the subgroups mentioned corresponds to a cause-dependent subdivision. Calcinosis cutis is not always used exclusively for skin deposits. The use of the word in everyday clinical practice is complex and at times somewhat vague.

causes

The deposit of calcium phosphate in the skin can have various causes. A conceivable cause is systemic diseases such as dermatomyositis , scleroderma syndrome in the form of CREST syndrome or progressive systemic scleroderma. In addition, the substance can accumulate after previous skin injuries.

In addition, the deposit can be the result of infections or occur in the context of chronic hypercalcemia and hyperphosphatemia due to metabolic disorders . Metastatic calcinosis is caused by a disturbance in the calcium phosphate metabolism. Metabolic disorders also characterize calcinosis metabolica.

In dystrophic calcinosis, there are no detectable disturbances in calcium metabolism. In this form, calcinosis accompanies tumors, phlebolites, varicose veins, tuberculous lymphomas or local trauma . Idiopathic calcinosis has no obvious cause and can therefore not be traced back to an external or internal influence.

In the case of iatrogenic calcinosis of the skin, the cause is to be sought in a treatment that the patient has received for other complaints. A benign calcinosis of unclear cause also exists with the tumorous calcinosis of Teutschländer’s disease, which causes slow tumor growth in soft tissue with adjacent large joints and is based on mutations in the genes coding for GALNT3, FGF23 and KLOTHO. Another cause is rheumatic processes or ochronosis .

Symptoms, Ailments & Signs

The symptoms of calcinosis cutis can vary in severity. In this context, metabolic calcinoses are divided, for example, into the subgroups calcinosis circumscripta and calcinosis universalis. In the case of the first phenomenon, the calcium salts are stored locally in the form of individual nodules in the skin and possibly the joints, where they can cause restricted movement , pain or stiffness .

This form of calcinosis is also known as calcinosis localisata. The calcinosis universalis, generalisata or diffusa is accompanied by numerous deposits in the skin. In addition, the subcutaneous tissue can be affected by the deposits. The same applies to organs. This severe form of calcinosis is known as lipocalcinogranulomatosis and is not, strictly speaking, calcinosis cutis.

Instead, calcinosis cutis is one of many symptoms of this phenomenon. Deposits in the internal organs are also conceivable in the case of metastatic calcinosis and then usually affect the kidneys, stomach or lungs. Due to the deposits, the organs involved can be affected by functional impairments in the case of severe calcinosis.

As a rule, the clinical picture of calcinosis cutis is characterized by macroscopically visible, hard palpable swellings . Local inflammation often occurs as well . Epidermal plaque breakthroughs can also occur. Calcium deposits in the intervertebral discs are also conceivable with intervertebral calcinosis.

Diagnose

The diagnosis of calcinosis cutis is based on the clinical picture, the medical history and imaging. A tissue sample can be useful to confirm the first suspected diagnosis. Laboratory examination of this sample unmasks the calcium phosphate. The detection of the primary cause plays a key role in diagnostics. The prognosis of patients depends on the causative disease. The same applies to therapy.

complications

The course of calcinosis cutis depends essentially on its cause and the specific localization. The deposition of calcium phosphates in the skin indicates many different underlying diseases, among which the one applicable to the affected person must be identified. In connection with these – sometimes serious – underlying diseases, further complications can of course occur that go beyond calcinosis cutis.

The calcium metabolism can be disturbed, for example, but tumors or tuberculosis can also be the cause. Among other things, this depends on where the calcinosis cutis occurs and how far it spreads. In the form of nodules, it causes complications such as pain, stiffness and limitations in mobility. Severe cases also affect the subcutaneous tissue or organs.

If the organs are affected, there is no classic calcinosis cutis, as this is limited to the skin in the narrower sense. However, they often interact with each other and calsinosis cutis can be a sign of more severe calcinosis. This can cause kidney, stomach or lung dysfunction. These organs are affected in most cases. While calcinosis in the skin can be removed relatively without complications, calcinosis of the organs requires more complicated surgical interventions.

When should you go to the doctor?

As a rule, calcinosis cutis does not heal itself. For this reason, medical treatment is definitely necessary for this disease in order to avoid further complications and symptoms. The doctor should be consulted if lumps form on the skin. The joints can also be affected, so that there may be restrictions in the patient’s movement. A doctor must also be consulted if the joints are very painful or if the patient becomes permanently unsteady.

Most of those affected also suffer from inflammation or swelling. If these occur without a particular reason, an examination by a doctor is also necessary. The disease can usually be diagnosed by a general practitioner. Further treatment depends on the cause and also on the exact symptoms. In some cases, calcinosis cutis can also have a negative effect on the internal organs, so these must also be treated.

Treatment & Therapy

Calcinosis cutis is usually treated surgically. The invasive removal of the deposits is accordingly the focus of the therapy. If the calcinosis is limited to the skin, this procedure is more or less simple and usually does not require hospital admission. Often the treatment can be performed under local anesthesia of the affected skin areas.

If there is organ involvement, removal is more difficult. In addition to general anesthesia , this requires precise planning of the intervention, which usually takes place with the help of imaging procedures such as MRT . The removal of the calcium deposits corresponds to a symptomatic treatment only. Therefore, the intervention must be accompanied by a causal therapy of the primary disease.

Acute hypercalcemia can often be controlled by the administration of loop diuretics and glucocorticoids , since this supports elimination via the kidneys. There are no causal therapies available for some causes of calcinosis, so treatment in these cases is purely symptomatic. The same applies to idiopathic calcinosis whose cause is not discovered.

Outlook & Forecast

The causative disease and the severity of the calcium attack are essential for the provision of a prognosis for calcinosis cutis. Many patients do not achieve permanent freedom from symptoms because chronic diseases or system disorders are diagnosed. Here a chronic continuous prognosis is given. In many of these patients, the calcium level in the organism is treated and monitored in long-term therapy. Symptoms are alleviated and surgical interventions can be avoided or reduced.

If the underlying disease is progressive, the symptoms recur despite removal of the calcium. Surgical removal of plaque is repeated throughout life. A metabolic disorder can be treated well with medication. Nevertheless, a recurrence is also very likely here.

If calcinosis cutis has developed as a result of an infection following a skin injury, the prognosis is best. In most cases, the patient experiences permanent relief of symptoms after the surgical procedure and removal of the plaque. If there are no sequelae, the patient is discharged from treatment within a few weeks as cured.

The prognosis worsens if tumors or tuberculosis are found to be responsible for the calcinosis cutis. Despite numerous medical advances, there is a potential danger to life for those affected.

prevention

Calcionsis cutis cannot be prevented comprehensively, since not all causes of the phenomenon have been detected so far.

aftercare

Follow-up care is possible in some cases of calcinosis cutis. In any case, the person concerned should avoid the occurrence of the disease and find out the cause of the deposits in order to stop them completely. The surgical treatment of calcinosis cutis is usually carried out without complications and does not require an inpatient stay in the hospital, so that follow-up care is no longer necessary.

However, even after treatment, regular visits to the doctor are necessary to avoid further complications. The disease can also be combated by taking medication, whereby the person concerned must ensure that it is taken regularly in order to permanently relieve the symptoms.

In some cases, causal therapy is not possible, so that only symptomatic treatment can be given. The life expectancy of the patient is usually not negatively affected by the disease. Furthermore, calcinosis cutis can also lead to psychological problems or depression .

Bullying or teasing is common, especially in children, so psychological treatment can also be useful. In the case of calcinosis cutis, the parents can also take part in the psychological treatment and support the child.

You can do that yourself

Calcinosis cutis is usually treated surgically. The most important self-help measure is to follow the doctor’s instructions regarding personal hygiene and diet after the operation. First of all, the body and especially the skin should not be put under too much strain so that no further skin changes and other complications occur.

At the same time, the diet has to be changed. Which diet is suitable in detail depends on the severity of the skin calcifications. In the case of mild symptoms, it is sufficient to avoid skin-irritating foods and drinks. Food that is too salty or spicy should not be eaten. Alcohol and caffeine are also best avoided.

In consultation with the dermatologist , various natural remedies can be used. Aloe vera and preparations with devil’s claw as well as pads with chamomile or sage have proven themselves . Measures such as yoga or qigong stimulate blood flow and thus support calcinosis cutis therapy.

If the measures described do not have the desired effect or if skin calcifications occur again, the dermatologist must be consulted. Patients should consult the doctor closely and consult other specialists so that the necessary treatment measures can be initiated immediately in the event of any accompanying symptoms.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.