Cutaneous calcification following liver transplantation

Ectopic calcification following liver transplantation has been reported to occur in various internal organs but there have been few reports of skin involvement. The pathogenesis is uncertain with previous reports suggesting that the calcifications could be either dystrophic or metastatic. The large amount of intravenous calcium needed to correct hypocalcaemia secondary to blood product transfusion is thought to play a central role. We report a case of calcinosis cutis developing after liver transplantation in a 22-year-old woman at sites where no intravenous calcium had been administered. In previously published cases serum calcium and phosphate levels were reported as normal. In our case serum calcium levels were also within or below normal limits with the exception of a transient rise in the immediate post-operative period. Our case supports earlier hypotheses that short-lived and often undetected elevations in the calcium-phosphate product are implicated in this condition.