Presentation
Here, we present the case of a 67-year-old man with multiple sclerosis on chronic dexamethasone and concurrent supplementation of calcium and daily cholecalciferol presenting with painful calcified lesions. [ncbi.nlm.nih.gov]
Entire Body System
-
Gangrene
[…] calcification-cutaneous necrosis syndrome Clinical Features: Complication of renal failure, especially when there is secondary or tertiary hyperparathyroidism Painful violaceous lesions, most common on the trunk and extremities, which may progress to form ulcers and gangrene [dermpedia.org]
In very severe cases, the skin may become gangrenous at the affected site. Pictures Calcinosis cutis pictures from Dermatology Atlas Brazil courtesy of Samuel Freire da Silva, M.D. [healthhype.com]
-
Noncompliance
On 6-month follow-up, this patient had only mild improvement after treatment with an anti-itch lotion and aluminum hydroxide, with which she was noncompliant. [ncbi.nlm.nih.gov]
-
Anorexia
She developed progressively increasing disk-like masses of calcinosis over the gluteal regions, knee, elbow, and ankle joints fixed to the overlying skin associated with malaise, anorexia, and weight loss. [ncbi.nlm.nih.gov]
Respiratoric
-
Respiratory Distress
A 37-year-old white man diagnosed with multiple myeloma was admitted for respiratory distress. [ncbi.nlm.nih.gov]
Musculoskeletal
-
Muscle Tenderness
There was no Raynaud's phenomenon, dysphagia, dyspnoea, sclerodermatous skin, sclerodactyly, telangectasias, or muscle tenderness/weakness. [ncbi.nlm.nih.gov]
Urogenital
-
Swelling of the Scrotum
Iatrogenic and traumatic calcinosis are those types which are associated with medical procedures. [1], [2] Case 1 30 year old male presented with multiple swelling in the scrotum of three months duration. [jlponline.org]
Workup
During the preop workup, careful clinical assessment had revealed multiple subcutaneous nodules affecting the extensor musculature limited to the gluteal region, anterior and posterior aspects of the thigh. [ncbi.nlm.nih.gov]
It can be of four types: dystrophic, metastatic, idiopathic, and iatrogenic. [1] Following clinical diagnosis of calcinosis cutis, a thorough laboratory workup must be carried out to detect the underlying cause. [amhsjournal.org]
A hormonal workup, including calcitonin, parathyroid hormone, and thyroid hormone levels, was also within normal limits. [karger.com]
Serum
-
Hyponatremia
He was found to have hypercalcemia (13.1 mg/dL), hyperphosphatemia (7.2 mg/dL), hyponatremia (121 mEq/L), and acute renal failure (serum urea nitrogen, 116 mg/dL; creatinine, 4.9 mg/dL). [ncbi.nlm.nih.gov]
Metabolic panel showed mild hyponatremia at 132 mmol/L, erythrocyte sedimentation rate of 120 mm/hour, C-reactive protein of 20.6 mg/L, hyperglycemia at 195 mg/dL, uremia, and decreased CO 2. [woundsresearch.com]
[…] treatment with prednisone, despite having received the intravenous hyperhydratation, diuretic therapy (intravenous furosemide) and anti-uricolytic therapy (oral allopurinol) from the beginning, she developed a severe tumor lysis syndrome (TLS) with hyponatremia [file.scirp.org]
Treatment
Therapy for calcinosis cutis consisted of medical treatment alone (n 19), surgical therapy alone (n 11), combined medical and surgical treatment (n 17), no treatment (n 30), and unknown (n 1). [ncbi.nlm.nih.gov]
Prognosis
These patients manifest without cutaneous involvement, but do not differ in its clinical or laboratory features and prognosis from classical systemic sclerosis. [ncbi.nlm.nih.gov]
Complications & Prognosis The prognosis of calcinosis cutis is generally good and calcium deposits typically improve gradually over time depending on correction of the underlying cause of disease. [animalallergycolorado.com]
This subtyping is closely related to the prognosis and response to treatment. [jlponline.org]
However, the prognosis is not usually as serious with calcinosis cutis. The condition can lead to severe disfigurement, superficial pain and skin ulcers. In rare instances, it can lead to gangrene due to blockage of blood flow. [healthhype.com]
Etiology
Due to its multifactorial pathogenesis, several subtypes and potential etiologies have been described. [ncbi.nlm.nih.gov]
(See "Calcinosis cutis: Etiology and patient evaluation" and "Calciphylaxis (calcific uremic arteriolopathy)", section on 'Treatment' .) [uptodate.com]
It is classified into 4 major types according to etiology: dystrophic, metastatic, iatrogenic, and idiopathic. [ajnr.org]
Epidemiology
Epidemiology Calcinosis cutis commonly occurs in patients with systemic sclerosis, especially the limited form (CREST). [statpearls.com]
Pathophysiology
The pathophysiology remains unclear and no effective therapy is currently available. We report a 30-year-old woman with a 13-year history of SLE who developed multiple calcinosis cutis around both knees and we review the relevant published work. [ncbi.nlm.nih.gov]
The pathophysiology of calcinosis cutis is not well understood, and there is a broad range of severity seen, from benign localized, small nodules to large, severely debilitating lesions (2). [clinicaltrials.gov]
Discussion Pathophysiology Various theories have been suggested regarding the elusive pathophysiology of CC. 1,4,7 Local alkaline phosphatase (ALP) elevations may lead to hydrolysis of extracellular pyrophosphates, which usually act to inhibit calcium [woundsresearch.com]
Prevention
A total hip arthroplasty using the posterior approach was performed with minimal trauma to the calcified nodules and thereby preventing a source of persistent drainage and reducing morbidity due to infection. 2017 BMJ Publishing Group Ltd. [ncbi.nlm.nih.gov]
There are currently no effective medical therapies for the prevention or treatment of calcinosis. [consano.org]
Your skin Holds body fluids in, preventing dehydration Keeps harmful microbes out, preventing infections Helps you feel things like heat, cold, and pain Keeps your body temperature even Makes vitamin D when the sun shines on it Anything that irritates [icdlist.com]
While various therapeutic modality have been used, no treatment has convincingly prevented or reduced calcinosis. We report two cases of calcinosis cutis combined with rheumatic disease. [synapse.koreamed.org]
Keep ulcerated areas clean and prevent pet from rubbing, scratching, licking or biting the irritated area. There is no specific treatment for calcinosis cutis, however, the underlying disease process must be addressed to help resolve this condition. [animalallergycolorado.com]