Calcinosis dystrophica localized L94.21

Aetiologically unexplained deposition of calcium salts in pathologically altered cutis, subcutis or muscles, without detectable calcium or phosphate metabolic disturbance.

The term calcinosis dystrophica is generally equated with the terms calcinosis metabolica and calcinosis idiopathica. Dystrophic calcioses occur in scars, chronic inflammatory infiltrates, cysts, epitheliomas, carcinomas, hemangiomas in organized thrombophlebitis (phlebolite) and others.

Furthermore one can choose between:

• localized cutaneous
• and
• disseminated

dystrophic calcinosis. The disseminated dystrophic calcinoses are mainly observed in the following systemic diseases:

• Thibièrge-Weissenbach syndrome
• CREST syndrome
• Ehlers-Danlos Syndrome
• Pseudoxanthoma elasticum
• Progeria adultorum

Unknown; serum calcium-phosphate levels are normal in calcinosis (cutis) dystrophica, probably due to local degenerative tissue processes calcification in these arals.

First manifestation in middle to old age: 50-70 years

Often located acrally, in the area of the distal finger sections, on the elbows and knees, on the ears and lower leg (chronic cold damage); rarely in the area of the scrotum (epidermal cysts) or in the depth of the adductor muscles of the thigh (chronic trauma in riders).

Single or multiple, whitish-yellowish, very hard, mostly painless plates, nodules and needles in the skin and subcutis which are (very) painful only in cases of fingertip calcinosis, with a tendency to ulceration due to perforation of the calcific conglomerates. In the case of ulcer formation, the white hard calcareous concretions can be detected at the base of the ulcer. Calcific plates can also be located subcutaneously or occur in the musculature (rider bones).

Systemic scleroderma is typically characterized by acral, very painful calcifications of the skin (the term acrocalcinosis is also used for this).

1. Bégon E et al (2014) Symptomatic dystrophic cutaneous calcification as a late complication of radiotherapy for breast cancer. Int J Dermatol 53:e542-544
2. Delgado-Márquez AM et al (2015) Effectiveness of extracorporeal shock wave lithotripsy to treat dystrophic calcinosis cutis ulcers. Actas Dermosifiliogr 106:140-143
3. Deza G et al (2015) Solitary Plaque-type Morphea with Dystrophic Calcinosis Cutis. Acta Derm Venereol doi: 10.2340/00015555-2271