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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

Picture of Calcinosis on Fingertip
Image of Calcinosis on Fingertip
in Systemic Sclerosis
ISN Photo Repository
Contributed by Jorgie

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. (Also see Calcinosis Photos)

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

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.

Are there risk factors for scleroderma-related calcinosis? Calcinosis was common in both limited and diffuse systemic sclerosis; both longer disease duration and osteoporosis were independently associated with calcinosis. PubMed, Mod Rheumatol, 2017 Jul 19:1-5.

Calcinosis is associated with digital ischaemia in systemic sclerosis (SSc) – a longitudinal study. Ischaemia may play a role in the development of calcinosis in SSc. PubMed, Rheumatology (Oxford), 09/04/2016. (Also see Digital Ulcers)

Photos of Calcinosis

Scleroderma Photos: Calcinosis

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

Diagnosis

Scleroderma Diagnosis. Calcinosis can be caused by many disorders. It can also be caused by systemic sclerosis. It is one of the criteria for diagnosis of Limited/CREST systemic scleroderma. ISN.

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

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." Medscape.

Calcinosis in poly–dermatomyositis (DM): clinical and laboratory predictors and treatment options. DM diagnosis and positivity for PM/Scl and NXP-2 could all be considered risk factors which foresee the development of calcinosis. PubMed, Clin Exp Rheumatol, 2017 Mar-Apr;35(2):303-308.

Case Report: Acro–osteolysis and calcinosis in patient with scleroderma. We present a unique case of progressive acro–osteolysis of the distal phalanges and articular calcifications in a patient with scleroderma. PubMed, Acta Orthop Traumatol Turc. (Also see Bone Resorption)

Calcinosis: pathophysiology and management. This article reviews the most updated literature regarding the epidemiology, pathophysiology, diagnosis, and treatment of calcinosis cutis in patients with systemic sclerosis (SSc). PubMed, Curr Opin Rheumatol, 2015 Nov;27(6):542–8.

Late nailfold videocapillaroscopy (NVC) patterns associated with hand calcinosis and acro-osteolysis in systemic sclerosis (SSc). Acro–osteolysis and calcinosis are independently associated with the late NVC pattern, and particularly with severe capillary loss. PubMed, Arthritis Care Res (Hoboken), 07/20/2015. (Also see Bone Resorption in SSc and Nailfold videocapillaroscopy)

Treatment

Generally, there is no treatment required for calcinosis, although surgical excision is sometimes done for extensive or very painful calcinosis.

Colchicine is often used to reduce inflammation associated with calcinosis. MedicineNet.

Calcinosis Cutis: WOC Nurse Management. Despite the lack of a standardized approach to treatment of calcinosis cutis, successful management of these patients was achieved by adhering to evidence-based wound-healing principles. PubMed, J Wound Ostomy Continence Nurs, 2018 Jan/Feb;45(1):83-86. (Also see Wound Healing in Systemic Scleroderma)

Safety and efficacy of extracorporeal shock wave therapy (ESWT) in calcinosis cutis associated with systemic sclerosis. Promising evidence was shown for safety and efficacy of ESWT for chronic, treatment resistant calcinosis cutis in SSc patients, thus justifying the initiation of larger multicentre controlled trials. PubMed, Clin Exp Rheumatol, 08/03/2016.

Validation of a Novel Radiographic Scoring System for Calcinosis Affecting the Hands of Patients with Systemic Sclerosis (SSc). We developed a novel radiographic scoring system that is feasible with excellent reliability, which accounts for the area coverage, density, and anatomic location of calcinosis affecting the hands in patients with SSc. PubMed, Arthritis Care Res.

(Case Report) 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. Rheumatology.

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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