대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis With Brief Discussion

Diagnosis

Calcinosis cutis universalis

Radiologic Findings

There are widespread calcification in the sofe tissuees of the trunk and extremities without evidence of bony pathology. Calcifications along subcutaneoutaneous tissue and muscles are noted. There is no remarkable abnormality in the lung parenchyma.

Brief Review

Calcinosis cutis is a term used to describe a group of disorders in which calcium deposits form in the skin. Calcinosis cutis is classified into 4 major types according to etiology: dystrophic, metastatic, iatrogenic, and idiopathic.

Calcinosis cutis generally is a benign process. However, when present, morbidity relates to the size and location of the calcification.
Idiopathic calcinosis also known as Calcinosis Universalis, is characterized by calcium deposits in dermis, subcutis and muscles without any metabolic disorder or tissue injury. The ultrastuructural morphology of localized skin calcifications without associated diseases and with normal serum calcium and phosphate ion values is still unknown. Calcium and phosphate excretion may be low. In the histological sections prepeared with Von Kosso dye, calcium depositions appear first in the adipose tissue and collogen fibrils. These depositions move into the cutis and subcutis and make diffuse salt agregates. X-ray examination or sonography of the extremities and trunk for dense shadows due to calcium is important. Biopsy plays an impartant role as well. The lesions may be ulcerated and painful. A creamy material containing calcium phosphate and calcium carbonate may drain from ulcerous lesions. This condition is known as Lipocalcinogranulamotosis. Draining sinuses develop while the ulcers heal. Usually there is no infection, malignancy or tissue injury, and biochemical parameters are also within normal limits.
Thibierge-Weissenbach syndrome, systemic sclerosis in childhood dermatomyositis, myositis ossificans progresiva and gout must be kept in mind for differential diagnosis.
Low calcium diet, excision of small lesions and EDTA (1200 mg daily for adults intravenously), with monitoring of renal function, may be helpful in treatment. 8

References

1.Ogretmen Z, Akay A, Bicakci C, Bicakci HC. Calcinosis cutis universalis. J Eur Acad Dermatol Venereol. 2002 Nov;16(6):621-4.
2. Cousins MA, Jones DB, Whyte MP, Monafo WW. Surgical management of calcinosis cutis universalis in systemic lupus erythematosus.Arthritis Rheum. 1997 Mar;40(3):570-2.

Keywords

Chest wall, Metabolic and storage lung disesae,