Childhood Calcinosis Cutis

Abstract

Calcinosis cutis, an uncommon disorder characterized by hydroxyapatite crystals of calcium phosphate deposited in the skin, has been described infrequently in childhood. Classically, it is divided into dystrophic, metastatic, and idiopathic types. We report an 8‐year‐old girl with hyperphosphatemia secondary to a tumor lysis syndrome, who developed a localized soft tissue calcification over a previous lesion of ec‐thyma gangrenosum. Intravenous infusion of calcium gluconate was probably the precipitating factor. Our case illustrates that several etio‐pathogenic mechanisms may be simultaneously involved in calcinosis cutis.

Successful Treatment of Severe Iatrogenic Calcinosis Cutis with Intravenous Sodium Thiosulfate in a Child Affected by T‐Acute Lymphoblastic Leukemia

“…In fact calcinosis cutis has been described in leukemic patients in association with hypercalcemia (7,8) and urolithiasis has also been described during prednisone treatment for leukemia even with normal serum calcium levels (9). We therefore suppose that factors other than calcium extravasation alone may have enhanced calcinosis cutis in our patient (10). Extravasated calcium could have triggered local tissue injury and inflammation, causing further cellular calcium release while tissue and cellular changes induced by concurrent chemotherapy and infection could have amplified this reaction (11) making it resistant to conventional treatment.…”

Firm Yellow Plaque on the Foot of a Young Infant

“…Furthermore, local tissue damage discharges alkaline phosphatase, increasing local pH and leading to the precipitation of calcium salts . According to Rodriguez‐Cano et al (), in the case of iatrogenic calcinosis cutis, local tissue damage causes phlebitis during briefly high levels of serum and tissue calcium, through which there are repeated trials to insert a peripheral line, and the extravasation of solution into the surrounding tissue may serve as an initiating factor. Furthermore, the free fatty acids released after fat cell necrosis caused by trauma could contribute to this process .…”

Dystrophic calcification following neonatal heel‐prick testing

“…This feature was seen in our patient on microscopy and reflected clinically by a collarette of scale surrounding the hyperkeratotic heel lesion. The literature describes spontaneous resolution after 18–30 months, 7 but also examples of persistence 2 . Lesions are often asymptomatic in the neonate, but later trauma from footwear may cause symptoms, necessitating removal 2 .…”