Calcinosis cutis.

1 of 2 DESCRIPTION An 87-year-old woman with a history of hypertension, atrial fi brillation, and mixed connective tissue disease was admitted to hospital because of heart failure. Besides clinical signs of ventricular dysfunction, physical examination showed painless, subcutaneous nodules that had developed during the past 10 years on her left elbow ( fi gure 1A ) and knees ( fi gure 1B , right knee; note a large deposit breaking through the skin). A radiograph of the left elbow ( fi gure 1C ) and right knee ( fi gure 1D ) demonstrated multiple, heterogeneous soft-tissue calcifi ed masses suggestive of calcinosis cutis. Her serum level of calcium, phosphate, intact parathyroid hormone and rheumatoid factor as well as renal function parameters were within normal limits. She afterwards died due to hospital-acquired pneumonia. Calcinosis cutis, described by Virchow 1 in 1855, refers to the deposition of insoluble calcium salts into the skin and subcutaneous tissue. It has been divided into four groups: metastatic, iatrogenic, idiopathic and dystrophic. 2