| SKIN INVOLVEMENT: MAIN MENU |
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Calcinosis |
| Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer |
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What is Calcinosis? |
 The 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. |
| Intraspinal (ISC) and Paraspinal Calcinosis (PSC) Associated with Systemic Sclerosis. PSC and ISC are closely associated with vascular complications in SSc, and may cause neurological manifestations crucially. Takehiko Ogawa. 8/8. ACR 2007. |
| Association between calciphylaxis and inflammation in two patients on chronic dialysis. The interactions between inflammation-mediated changes in the levels of endogenous inhibitors of calcification and abnormalities in calcium-phosphorus metabolism merit intensive study in the future as potential mechanisms of calciphylaxis. PubMed. Adv Perit Dial. 2006;22:171-4. (Also see: Dialysis) |
Diffuse Calcinosis |
| Disappearance of diffuse calcinosis following autologous stem cell transplantation in a child with autoimmune disease. Liquefaction of calcinosis nodules with improvement of mobility occurred gradually. She is now 24 months post-transplant with no sign of disease activity and total disappearance of calcinosis nodules. PubMed. Bone Marrow Transplant. 2004 Apr 12. (Also see: Stem Cell Transplant) |
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 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. |
| Expression of advanced glycation end products and their receptor in skin from patients with systemic sclerosis (SSc) with and without calcinosis. Our results indicate the possible contribution of AGE-CML [N{epsilon}-(carboxymethyl) lysine] deposition on the extracellular matrix in the dermis of the limited SSc with extracellular matrix subgroup to the pathogenesis of formation of calcinotic deposits. Christine A. Davies. Rheumatology. June 19, 2009. |
| Vitamin D, Parathyroid Hormone, and Acroosteolysis in Systemic Sclerosis. Low levels of vitamin D may reflect silent malabsorption and might be a risk factor for secondary hyperparathyroidism and bone resorption. Y. Braun-Moscovici. J Rheumatol. Oct 1 2008. (Also see: Vitamin D Deficiency and Bone resorption) |
| Erosive Arthropathy in systemic sclerosis. To determine radiological features of arthropathy in systemic sclerosis patients with polyarthritis. Three radiological patterns of abnormalities of joints (erosion: interruption of the cortical surface; space narrowing: focal or diffuse joint narrowing), bone (radiological demineralisation: juxta-articular or generalised osteoporosis; bone resorption), and soft tissue (calcifications) were assessed. Fadoua Allali. BMC Public Health. 2007; 7: 260. (Also see: Bone Resorption) |
| Paraspinal cervical calcifications associated with scleroderma. Although soft tissue calcifications are well known to occur as a late manifestation in scleroderma, symptomatic paraspinal calcinosis is very rare. Clinically, patients present with focal neck pain, weakness or radiculopathy, and decreased range of motion of the neck. PubMed. JBR-BTR. 2003 Mar-Apr;86(2):80-2. (Also see: Skeletal Involvement) |
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... |
