Multicentric Study on High‐Frequency Ultrasound Characterization of Calcium Deposits in Dermal and Subcutaneous Calciphylaxis and Calcinosis

Abstract

Objectives Calcium depositions are frequent in multiple inflammatory dermatosis, they can be explored by ultrasound (US) but the patterns of these depositions have not yet been described. The aim of this study is to describe different patterns of calcium deposition in inflammatory dermatoses. Methods The clinical and US data of 58 patients from 7 different centers with inflammatory dermatosis showing ultrasonography‐detected calcium depositions was retrospectively reviewed. Results Dystrophic calcinosis represented 86.2%, calciphylaxis 8.6%, and metastatic calcinosis 5.2%. Three different sonographic patterns of calcium deposition were found: 1) thin hyperechoic bands, parallel to the surface of the epidermis, generating a strong and wide posterior acoustic shadow; 2) hyperechoic spots or lumps with a narrow acoustic shadow; and 3) a linear hyperechoic band parallel to the walls of a blood vessel with also a narrow acoustic shadow. The predominant pattern in metastatic calcifications was type 1, in dystrophic calcifications type 2, and in calciphylaxis type 3. In dystrophic calcinosis, cutis deposits were longer and wider than in calciphylaxis (P < .05). Conclusion New data on inflammatory dermatoses with calcium deposition may be useful for the diagnosis and monitoring of calcium deposits and could avoid the performance of more invasive tests, such as a skin biopsy.

Calciphylaxis and Kidney Disease: A Review

“…Sonographic characteristics that have been associated with calciphylaxis include the presence of thin hyperechoic bands parallel J o u r n a l P r e -p r o o f 9 to the epidermal surface generating a strong posterior acoustic shadow, hyperechoic spots with a narrow acoustic window, and linear hyperechoic bands parallel to the walls of a blood vessel with a narrow acoustic shadow. 46,47 Both plain radiographs and POCUS have been used to diagnose calciphylaxis in various settings, including the Emergency Department (ED). 48,49 Imaging may be especially important to make this diagnosis in anatomical sites that are challenging to biopsy, such as the breasts.…”