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Calcinosis

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Overview
Photos of Calcinosis
Diagnosis
Treatment
Stories

Overview: What is Calcinosis?

CalcinosisThe systemic forms of scleroderma can cause small white calcium lumps to form under the skin on fingers or other areas of the body.

This is called calcinosis . The lumps may break through the skin and leak a chalky white liquid.

These most commonly occur on the hands, or near joints such as elbows or knees, although they may appear anywhere. Calcinosis may range from one very tiny deposit, to large (and often painful) clusters.

A few conditions other than scleroderma may also cause calcinosis, such as dermatomyositis, lupus, Vitamin D, tumors, and parasitic infections.

Photos of Calcinosis. See pictures of calcinosis in ISN Photo Repository. ISN.
Calcinosis is one of the symptoms of CREST Syndrome, which is a form of systemic scleroderma. Calcinosis is not caused by too much calcium in the diet.

Photos of Calcinosis

Scleroderma Photos: Calcinosis
Photo of Calcinosis Cutis on Buttocks, in Dermatomyositis. (This is an absolute worst case of calcinosis.) DermIS.

Diagnosis

Sometimes calcinosis isn't visible, and is detected only by X-ray.
Calcinosis Cutis "Calcinosis cutis is a term used to describe a group of disorders in which calcium deposits form in the skin." eMedicine Journal
A few conditions other than scleroderma may also cause calcinosis, such as dermatomyositis, lupus, Vitamin D, tumors, and parasitic infections.
Calcinosis in juvenile dermatomyositis is influenced by both anti-NXP2 autoantibody status and age at disease onset. The presence of anti-NXP2 autoantibodies substantially increases the risk of calcinosis across all ages and is associated with disease severity. PubMed, Rheumatology (Oxford), 2014 Jul 1. (Also see: Dermatomyositis Symptoms)
Calcinosis cutis in autoimmune connective tissue diseases. Recommendations for the diagnosis and therapy of calcinosis cutis in patients with autoimmune connective tissue diseases are discussed. Dermatol Ther. 2012 Mar;25(2):195-206.

Treatment

Generally, there is no treatment required for calcinosis, although surgical excision is sometimes done for extensive or very painful calcinosis.
Lumbar canal spinal stenosis due to axial skeletal calcinosis and heterotopic ossification in limited cutaneous systemic sclerosis: successful spinal decompression Peripheral cutaneous calcinosis is well recognized in lcSSc, but axial skeletal calcinosis is less common. We present a case of lcSSc with lumbar canal spinal stenosis due to calcinosis and heterotopic ossification that had successful decompressive spinal surgery. Anita Weerakoon, Rheumatology, 28 August 2011 (Also see: Skeletal Involvement)
Therapeutic management of acral manifestations of systemic sclerosis. Acral manifestations of systemic sclerosis include Raynaud's phenomenon, calcinosis cutis, and sclerodactyly. In the later stages of the disease, contractures of the skin and joints as well as obliterative vasculopathy leading to digital ulcers and necrotic lesions may occur. PubMed. Med Klin (Munich). 2007 Mar 15;102(3):209-18. (Also see: Raynaud's, Sclerodactyly, Digital Ulcers, and Skeletal Involvement: Joint Contractures)
Calcinosis in rheumatic diseases. While warfarin, colchicine, probenecid, bisphosphonates, diltiazem, minocycline, aluminum hydroxide, salicylate, surgical extirpation, and carbon dioxide laser therapies have been used, no treatment has convincingly prevented or reduced calcinosis. However, the approach to calcinosis management is disorganized, beginning with the lack of a generally accepted classification and continuing with a lack of systematic study and clinical therapeutic trials. PubMed. Semin Arthritis Rheum. 2005 Jun;34(6):805-12.
Surgical treatment of destructive calcific lesions of the cervical spine in scleroderma. Destructive, calcific masses in the cervical spine associated with scleroderma and an indication for surgical treatment are rare. Treatment is complex and not without significant risk to the patient. PubMed. Spine. 2006 Aug 1;31(17):2002-8. (Also see: Skeletal Involvement)
Regression of cutis calcinosis with diltiazem in adult dermatomyositis. Calcinosis cutis is common in several connective tissue diseases such as dermatomyositis, scleroderma or lupus erythematous. We report a case of adult cutis calcinosis associated with dermatomyositis which responded dramatically to treatment with diltiazem. PubMed. Eur J Dermatol. 2005 Mar-Apr;15(2):102-4. (Also see: Dermatomyositis)
Surgery of the hand in patients with systemic sclerosis: outcomes and considerations. The goals of surgery for advanced SSc affecting the hand are limited and include pain relief through sympathectomy and increased perfusion, repositioning the digit, providing a functional position of fusion, and modest mobilization through resection arthroplasty. J Rheumatol. 2005 Apr;32(4):642-8. (Also see: Sclerodactyly, Skeletal Involvement, and Raynaud's Treatments)
Calcinosis: A pilot study of acetic acid iontophoresis and ultrasound in the treatment of systemic sclerosis-related calcinosis. In this small pilot study none of the patients experienced clinical improvement, despite an intensive treatment schedule over 3 weeks. However, there may have been some radiographic improvement. PubMed. Rheumatology (Oxford). 2005 Jan 11.
Colchicine
Colchicine is often used to reduce inflammation associated with calcinosis.MedicineNet.

Stories

Angela O: CREST Now, the calcinosis is so bad on my fingers, that I find ordinary chores harder and harder...
(Update) Christine S: Diffuse Scleroderma, Stage 2 It has been three years since my story was posted on this page and trust me, life has not slowed an iota—medically speaking at least...
Craig R: CREST Scleroderma I had my first scleroderma symptoms at age twenty-two, which included severe Raynaud's with some ulceration and tissue loss...
Debby: CREST Scleroderma It was then everything added up—that I did not have several different conditions, but rather they were all part of the CREST...
Dodo: Limited Systemic Scleroderma (Italy) The tips of my fingers turned cold, and then became cyanotic, always hurt and in the end they became ulcerated...
(Italiano) Dodo: Sclerodermia Sistemica Limitata (Italia) Ho iniziato ad avere alcune punte delle dita delle mani molto fredde, che in pochi giorni diventarono prima cianotiche, sempre piú doloranti e infine presentarono delle ulcere...
Doni: CREST Syndrome The doctors were always interested like, "Wow look at this," but since I had no insurance, they would not touch me...
Elaine L: Scleroderma When I was about twenty years old, I started experiencing stomach problems and my fingers would turn a waxy white and feel so cold...
Eli: Sclerodermia and Raynaud's Syndrome (Italy) After thirteen years of suffering, he has given me a diagnosis and a cure, before it is too late, I hope...
(Italiano) Eli: Sclerodermia e Sindrome di Raynaud (Italia) Finalmente dopo 13 anni di sofferenza ho diritto anche io a una diagnosi e una cura,prima che sia troppo tardi. Spero...
Gipi: Raynaud's, Scleroderma (Italy) I'm a fifty-three-year-old woman. When I was twenty-one my illness began, my fingers turned white and I had pain in my bones...
(Italiano) Gipi: Raynaud's, Sclerodermia Sono una donna di 53 anni. Quando avevo 21 anni ho avuto l'esordio della mia malattia con pallore alle dita delle mani e dolori alle ossa...
Helen P: CREST Scleroderma I was diagnosed ten years ago when the symptoms kicked in with a vengeance following a very traumatic personal tragedy...
Jay: Scleroderma and CREST When I was fifteen or so, I noticed that my fingertips were starting to get very sore...
Jerri: CREST Syndrome I was twenty-one years of age when I first noticed that my fingers, toes and lips were turning colors...
Jewell: Diffuse Progressive Systemic Sclerosis When I think back, I had been getting sick for a long time. I just did not know it...
Kathy Baker: CREST Scleroderma (Houston, Texas) This disease has been a roller coaster ride both emotionally and physically, but I know it could be worse...
Mary T: CREST Scleroderma If my rheumatologist does not explain my problems to my satisfaction, I will be looking for another doctor...
Pat: CREST Scleroderma They had to do surgery and take calcium deposits out of my knee...
Robin T: CREST Syndrome My hands were always cold and turning white, purple then red then back to normal, and hurting. Then I developed a sore on my finger tip that wouldn't go away...
Rose M: CREST Syndrome I was finally correctly diagnosed with CREST after two years of thinking I was going crazy...
Rosemary F: Surviving Daughter of Diffuse Scleroderma Patient She tried to explain it, but it was hard for me to comprehend the disease's symptoms. Mom said that it was the same thing that her oldest sister died from...
Sandy A: CREST Syndrome I have had surgery to remove the calcinosis on my knee and forearm twice, and once on my elbow. Yet it always comes back...
ShaunTel: Scleroderma/CREST Since 1993, I have had doctors telling me so many different diagnoses that I believed I was really just making it up...
Tata P: Diffuse Scleroderma I am thirty-two years old, and I have been suffering this illness since I was nine...
(Español/Spanish) Tata P: Esclerodermia Difusa Hola, tengo 32 años, y padezco esta enfermedad desde los 9...
 
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