Cutaneous calcinosis in a neonate following extravasation of calcium gluconate

Cutaneous calcinosis following extravasation of calcium gluconate in a 6-day-old neonate is reported. After extravasation of a 10% calcium gluconate infusion, rapid and marked swelling, erythema, and signs of soft tissue necrosis developed over the dorsum of the right hand and wrist. Small eschars were soon formed on the skin surface and began to slough, the underlying base appearing necrotic. Through the small channels of the destroyed epidermis, tiny white pieces of calcific masses were eliminated spontaneously. Histologically, the dermal collagen was massively degenerated and the calcium deposits were found as amorphous masses throughout the dermis and subcutaneous adipose tissue, surrounded by mild lymphohistiocytic cell infiltration. This is a case which again warns of the danger of using 10% calcium gluconate intravenously in the neonate or young infant.