Iatrogenic calcinosis cutis: a rare diagnosis

Abstract

Calcinosis cutis involves abnormal calcium deposition in the skin and subcutaneous tissues. The iatrogenic form is rare and typically follows medical or cosmetic procedures. A 60-year-old male presented with multiple asymptomatic, skin-coloured nodules on both cheeks, present for over a decade. He had a history of autologous fat grafting for acne scars 15 years prior. Clinical examination revealed firm subcutaneous papulo-nodules. Imaging (ultrasound, X-ray, and CT scan) confirmed multiple subcutaneous calcifications. Laboratory tests, including calcium, phosphate, and vitamin D levels, were normal. Biopsy was declined. Based on the procedural history and imaging, a diagnosis of iatrogenic calcinosis cutis was made. Iatrogenic calcinosis cutis may develop following local tissue injury, as seen here with fat grafting. Fat necrosis and subsequent calcification likely contributed to the lesion formation. Imaging played a crucial role in diagnosis when biopsy was not feasible. This case highlights an unusual complication of cosmetic procedures and underscores the importance of imaging and thorough clinical evaluation in diagnosing calcinosis cutis. Awareness of such presentations helps avoid unnecessary interventions.