Iatrogenic Calcinosis Cutis in the Pediatric Patient: Case Report and Literature Review

• Published in: Plastic and reconstructive surgery. Global open Vol. 11; no. 3; p. e4837
• Main Authors: Manrique, Monica, Escandón, Joseph M, Paredes-Gutierrez, Juliana, Mantilla-Rivas, Esperanza, Nasser, Jacob S, Oh, Haley S, Duarte-Bateman, Daniela, Oh, Albert K, Rogers, Gary F
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01.03.2023; Wolters Kluwer
• Subjects: Case Report; Craniofacial/Pediatric
• ISSN: 2169-7574; 2169-7574
• DOI: 10.1097/GOX.0000000000004837

Calcinosis cutis is the term used to describe the deposition of calcium compounds within the skin and subcutaneous tissue, which can occur after the administration of intravenous calcium compounds. Its etiology is broad, and the clinical presentation is variable, creating a diagnostic challenge. Although iatrogenic calcinosis cutis is extremely uncommon, awareness and early diagnosis of this entity can reduce the risks of severe complications, including soft tissue damage, restricted joint mobility, and even nerve compression. Clinical suspicion should prompt a thorough review of the medical history and appropriate radiographic studies. Evidence of extensive soft tissue calcification must be present on radiographic imaging to confirm the diagnosis. Iatrogenic calcinosis cutis is managed conservatively, and resolution of symptoms is expected within 2 months of symptom onset. Herein we report the case of an infant with DiGeorge syndrome who developed iatrogenic calcinosis cutis after receiving an intraoperative infusion of calcium gluconate. Our patient presented with right lower extremity swelling, erythema, and warmth over a broad area of the leg centered on the entry point of the venipuncture. This was initially mistaken and managed as cellulitis, but once an accurate diagnosis was made, the symptoms gradually resolved with conservative care and no functional sequelae. We also present the literature on iatrogenic and idiopathic calcinosis cutis in the pediatric population.