Cutaneous Calcification

  • Franz TrautingerEmail author
Living reference work entry


Normally, calcium and phosphate are in a relatively stable equilibrium in extracellular fluids. In ectopic calcifications, precipitation and deposition of solid material occur in connective tissue, and in rare cases with formation of bony structures (heterotopic ossification) too. Mostly, however, no crystalline calcium salts but rather amorphous precipitates of calcium phosphate and calcium carbonate occur. If these precipitates, which may also contain other ions in addition to calcium, are deposited in dermal and subcutaneous connective tissue, the resulting diseases are collectively referred to as cutaneous calcinoses. The classification of calcinoses depends on their pathogenesis: metastatic calcinosis cutis develops in normal tissues with disturbed calcium and/or phosphate metabolism. More frequently, dystrophic calcinosis cutis occurs in damaged or traumatized tissues without underlying metabolic disorder. The entities formerly referred to as idiopathic calcinoses (solitary congenital nodular calcification, calcinosis of the scrotum/vulva and auricular calcinosis) must be classified as dystrophic calcinoses. The term idiopathic calcinosis is therefore not used in this chapter.


  1. Balin SJ, Wetter DA, Andersen LK, Davis MDP (2012) Calcinosis cutis occurring in association with autoimmune connective tissue disease. The Mayo Clinic experience with 78 patients, 1996–2009. Arch Dermatol 148:455–462CrossRefGoogle Scholar
  2. Eich D, Scharffetter-Kochanek K, Weihrauch J et al (2004) Calcinosis of the cutis and subcutis: an unusual nonimmunologic adverse reaction to subcutaneous injections of low-molecular-weight calcium-containing heparins. J Am Acad Dermatol 50:210–214CrossRefGoogle Scholar
  3. Hafner J (2016) Calciphylaxis and Martorell hypertensive ischemic leg ulcer: same pattern – one pathophysiology. Dermatology 232:523–533CrossRefGoogle Scholar
  4. Ichikawa S, Baujat G, Seyahi A et al (2010) Clinical variability of familial tumoral calcinosis caused by novel GALNT3 mutations. Am J Med Genet 152A:896–903CrossRefGoogle Scholar
  5. Kalajian AH, Malhotra PS, Callen JP, Parkter LP (2009) Calciphylaxis with normal renal and parathyroid function: not as rare as previously believed. Arch Dermatol 145:451–458PubMedGoogle Scholar
  6. Li Q, Uitto J (2013) Mineralization/anti-mineralization networks in the skin and vascular connective tissues. Am J Pathol 183:10–18CrossRefGoogle Scholar
  7. McCarthy JT, El-Azhary RA, Patzelt MT et al (2016) Survival, risk factors, and effect of treatment in 101 patients with calciphylaxis. Mayo Clin Proc 91:1384–1394CrossRefGoogle Scholar
  8. Moss J, Syrengelas A, Antaya R et al (2006) Calcinosis cutis: a complication of intravenous administration of calcium gluconate. J Cutan Pathol 33:60–62CrossRefGoogle Scholar
  9. Nigwekar SU, Thadhani R, Brandenburg VM (2018) Calciphylaxis. N Engl J Med 378:1704–1714CrossRefGoogle Scholar
  10. Salmhofer H, Franzen M, Hitzl W et al (2013) Multi-modal treatment of calciphylaxis with sodium thiosulfate, cinacalcet and sevelamer including long-term data. Kidney Blood Press Res 37:346–3359CrossRefGoogle Scholar
  11. Sell EJ, Hansen RC, Struck-Pierce S (1980) Calcified nodules on the heel: a complication of neonatal intensive care. Pediatrics 96:473CrossRefGoogle Scholar
  12. Sultan-Bichat N, Menard J, Perceau G et al (2012) Treatment of calcinosis cutis by extracorporeal shock-wave lithotripsy. J Am Acad Dermatol 66:424–429CrossRefGoogle Scholar
  13. Walsh JS, Perniciaro C, Randle HW (1999) Calcifying basal cell carcinomas. Dermatol Surg 25:49–51CrossRefGoogle Scholar
  14. Yu WY, Bhutani T, Kornik R, Pincus LB, Mauro T, Rosenblum MD, Fox LP (2017) Warfarin-associated nonuremic calciphylaxis. JAMA Dermatol 153:309–314CrossRefGoogle Scholar

First Describer

  1. Selye H (1962) Calciphylaxis. University of Chicago Press, ChicagoGoogle Scholar
  2. Teutschländer O (1935) Über progressive Lipogranulomatose der Muskulatur. Zugleich ein Beitrag zur Pathogenese der Myopathia osteoplastica progressiva. Klin Wochenschr 14:451–453CrossRefGoogle Scholar
  3. Winer LH (1952) Solitary congenital nodular calcification of the skin. AMA Arch Derm Syphilol 66:204–211CrossRefGoogle Scholar
  4. Woods B, Kellaway TD (1963) Cutaneous calculi. Subepidermal calcified nodules. Br J Dermatol 75:1–11CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Department of Dermatology and VenereologyUniversity Hospital of St. PöltenSt. PöltenAustria

Section editors and affiliations

  • Roland Kaufmann
    • 1
  1. 1.Head of the Department of Dermatology, Venerology and AllergologyFrankfurt University HospitalFrankfurt am MainGermany

Personalised recommendations