• Francesca Bartoli
  • Laura Cometi
  • Marco Matucci-Cerinic


Calcinosis is a disorder characterized by deposition of calcium in the skin and subcutaneous tissues. In patients with systemic sclerosis (SSc), it is a late manifestation, most often occurring more than 7.5 years after the diagnosis. It typically involves the extremities such as hands and feet, particularly the fingers. Calcinosis can inflame, infect, ulcerate, and drain white chalky material. When infected, calcium deposits become more painful and debilitating and require the use of antibiotics and surgical removal. Scleroderma’s calcinosis can be considered a subtype of dystrophic calcification. The pathophysiology of calcinosis remains poorly understood; preliminary data suggest that digital vasculopathy, leading to insufficient blood flow and tissue hypoxia up to ischemia, may have a central role. Calcinosis is frequently associated with Raynaud’s phenomenon, esophageal alterations, sclerodactyly, and telangiectasia configuring the CREST syndrome. Hand radiographs are useful in detecting subcutaneous calcinosis in patients with SSc and to follow the progression.

To date, a universally used and broadly accepted classification of calcinosis is not available yet.

The presence of calcinosis, regardless of extension or severity, leads to morbidity and affects the life quality of patients suffering from scleroderma. Means to prevent or delay its occurrence have not yet been identified.


Calcinosis Dystrophic calcification Systemic sclerosis Scleroderma Ulcer Digital pitting scars Skin involvement CREST SSc Raynaud’s phenomenon 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Francesca Bartoli
    • 1
  • Laura Cometi
    • 1
  • Marco Matucci-Cerinic
    • 2
    • 3
  1. 1.Rheumatology DepartmentAzienda Ospedaliero – Universitaria CareggiFlorenceItaly
  2. 2.Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
  3. 3.Department of Geriatric Medicine, Division of RheumatologyAOUCFlorenceItaly

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