Abstract
Calcinosis cutis is a rare disorder characterized by deposition of insoluble calcium salts in skin and subcutaneous tissue. Depending upon the aetiology, there are five subtypes of calcinosis cutis described in the literature; dystrophic, metastatic, idiopathic, iatrogenic, and calciphylaxis. Idiopathic calcinosis cutis is rarely described in the literature. We herein report a 52-year-old female presented with calcinosis cutis in both hands. After ruling out metabolic and systemic causes of abnormal calcium deposition, the patient was diagnosed with idiopathic calcinosis cutis. The patient was prescribed oral diltiazem (1 mg/kg). Despite limited treatment success in idiopathic calcinosis cutis, it is imperative to differentiate it from other disorders of calcium metabolism which can be managed by treating the underlying condition.
Highlights
In calcinosis cutis, there is an abnormal deposition of calcium phosphate in the skin
Metastatic calcification occurs in patients with abnormal calcium/phosphate metabolism
It has been hypothesized that abnormal metabolism of gamma carboxy glutamic acid (GIa) is responsible for abnormal calcium deposition in subcutaneous tissues, with increased production of GIa is attributed to soft tissue calcification [8]
Summary
There is an abnormal deposition of calcium phosphate in the skin. Firm to hard, white to yellow papulonodular swellings on the finger pad of thumb, index and ring finger in right hand, little and middle finger of left hand (Figure 1A, 1B) With this clinical picture differential diagnosis of gouty tophi and calcinosis cutis were kept. On further evaluation, her radiograph of bilateral hand revealed multiple, heterogeneous soft tissue calcification in finger pads suggestive of calcinosis cutis (Figure 2). Her radiograph of bilateral hand revealed multiple, heterogeneous soft tissue calcification in finger pads suggestive of calcinosis cutis (Figure 2) She was investigated further to find the cause and her liver function, renal function tests, serum electrolytes, C-reactive protein, and erythrocyte sedimentation rate were within normal limit.
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