Table 2.

Summary of theories for the pathophysiology of calcinosis cutis.

MechanismEvidence
Chronic inflammationIncreased production of TNF, IL-1, IL-6, and other proinflammatory cytokines
Vascular hypoxia (ischemia)Hypoxia-induced imbalance between angiogenic factors (such as VEGF, platelet-derived growth factors) and antiangiogenic factors (such as angiostatin, endostatin)
Increased expression of the hypoxia-associated GLUT-1
Hypoxia-induced osteoclast activity
Recurrent traumaPresence or history of digital ulcers
Calcification occurs at sites of chronic trauma/stress, suggesting a role of pressure or recurrent trauma
  • GLUT-1: glucose transporter 1; IL: interleukin; TNF: tumor necrosis factor; VEGF: vascular endothelial growth factor.