CALCINOSIS CUTIS: MECHANISMS, DIAGNOSIS AND TREATMENT

Abstract

Calcinosis cutis is a dermatological condition characterized by the abnormal deposition of calcium salts in the skin and subcutaneous tissues, which may occur as a manifestation of autoimmune diseases, metabolic disorders, trauma, or idiopathic origin. It presents with a wide clinical spectrum, ranging from small indurated papules to large calcified masses, often progressing with pain, ulceration, secondary infection, functional limitation, and aesthetic impairment. The condition is classified into four main types: dystrophic, metastatic, idiopathic, and iatrogenic, with dystrophic calcinosis being the most frequent, particularly in association with scleroderma and dermatomyositis. Diagnosis requires clinical correlation, laboratory evaluation, imaging methods such as radiography and CT scans, and occasionally histopathological confirmation through biopsy. Treatment remains challenging and includes both conservative and surgical strategies, with drugs like diltiazem, bisphosphonates, probenecid, and sodium thiosulfate being used with varying degrees of success. Surgical excision may be indicated in refractory cases, especially when there is significant pain or recurrent infections. Despite increasing scientific interest, there is still a lack of robust clinical trials to define effective and standardized treatment protocols. Understanding the underlying pathophysiological mechanisms and providing individualized assessment are essential for optimizing clinical management and improving patient outcomes. Calcinosis cutis is, therefore, a multidisciplinary challenge that requires coordination between rheumatology, dermatology, surgery, and other medical specialties involved in comprehensive care.