Classification of calcinosis cutis and associations.
| Type of Calcification | Pathogenesis | Serum Calcium and/or Phosphorus Levels | Associated Diseases | Clinical Presentation |
|---|---|---|---|---|
| Dystrophic calcification | Secondary to tissue damage | Normal | Systemic sclerosis Dermatomyositis Lupus erythematosus Lupus panniculitis | Present as nodules, plaques, extensive small dermal, or large subcutaneous deposits |
| Metastatic calcification | Calcium precipitation in the skin | Abnormal | Chronic kidney failure Hyperparathyroidism Hypervitaminosis D sarcoidosis | Seen occasionally in the subcutaneous tissue as hard nodules located mainly in the vicinity of large joints |
| Idiopathic calcification | Unknown; no previous damage to skin or metabolic disturbances | Normal | Tumoral calcinosis Calcified subepidermal nodules (Winer’s nodular calcinosis) Scrotal calcinosis | Multiple, asymptomatic nodules, which begin to appear in childhood or in early adult life |
| Tumoral calcification | In patients with an elevated serum phosphorus level but normal calcium level | Presents as large subcutaneous calcium deposits near joints and pressure areas | ||
| Calciphylaxis | Calcification of the small vessel walls in the dermis and subcutaneous tissue, with subsequent ischemia | Abnormalities can be observed | Chronic kidney failure Other nonuremic causes | Subcutaneous nodules of infarction and necrotizing skin ulcers |