# Pathological calcification is seen in:
A. Scleroderma
B. Lichen planus
C. Dystrophic epidermolysis bullosa
D. Lupus erythematosus
The correct answer is A. Scleroderma.
Pathologic calcification is a common process in a wide variety of disease states; it implies the abnormal deposition of calcium salts, together with smaller amounts of iron, magnesium, and other minerals. When the deposition occurs in dead or dying tissues, it is called dystrophic calcification; it occurs in the absence of derangements in calcium metabolism (i.e., with normal serum levels of calcium). In contrast, the deposition of calcium salts in normal tissues is known as metastatic calcification and is almost always secondary to some derangement in calcium metabolism (hypercalcemia). Of note, while hypercalcemia is not a prerequisite for dystrophic calcification, it can exacerbate it.
Systemic sclerosis can be classified into two groups on the basis of its clinical course:
• Diffuse scleroderma, characterized by initial widespread skin involvement, with rapid progression and early visceral involvement
• Limited scleroderma, with relatively mild skin involvement, often confined to the fingers and face. Involvement of the viscera occurs late, so the disease in these patients generally has a fairly benign course. This clinical presentation is also called the CREST syndrome because of its frequent features of calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia.