Page 73 - Virtual Vascular Vol 13

Closer examination of the lower limbs showed that she has multiple hard subcutaneous
nodules fixed to underlying structures. These is not superficial thrombophlebitis or
thrombosed varicose vein.

This is calcinosis cutis, a rare condition in which calcium salts are deposited into the skin and
subcutaneous tissue. Calcinosis cutis is classified into five main types: dystrophic,
metastatic, idiopathic, iatrogenic, and calciphylaxis. Dystrophic calcification is the most
common cause of calcinosis cutis and is associated with normal serum calcium and

phosphorus levels, and is typically associated with a systemic disease such as systemic
sclerosis, lupus, dermatomyositis, mixed connective tissue disease, or induced by tissue
damage which creates a nidus for calcification (such as a chronic ulcer.

Treatment is mainly conservative, although steroids, bisphosphonates or minocycline can be
used with limited success.

Multiple hard nodules under the skin

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