Abstract

Calcinosis cutis is a form of dystrophic calcification wherein hydroxyapatite and amorphous calcium phosphate deposits form over damaged subcutaneous tissues despite normal serum Ca2+, PO43−, and parathyroid hormone (PTH) levels.1, 2 When it is widespread, major morbidity from restricted movement and pain are the primary presenting symptoms. Treatments reported include calcium binders (minocycline), calcium channel blockers, surgical excision, lithotripsy, and the calciomimetic sodium thiosulfate in topical, intralesional, or systemic form.3, 4, 5 Cutaneous calcification in these patients occurs due to damaged tissue releasing phosphate-binding proteins that bind serum phosphate, with subsequent precipitation of calcium salts in the tissue.2 In this study, we review 2 patients with recalcitrant calcinosis cutis who responded to apremilast after not responding to multiple other modalities to help mobilize calcium.

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