Calcium is vital to many biologic processes. In skin, it has a profoun
d effect on keratinocyte proliferation, differentiation, and cell-cell
adhesion. Serum calcium is tightly regulated by parathyroid hormone a
nd 1,25(OH)(2)D-3. Despite this careful regulation, calcification and
ossification of cutaneous and subcutaneous tissues may occur. Cutaneou
s calcification may be divided into four major categories: dystrophic,
metastatic, idiopathic, and iatrogenic. Dystrophic calcification occu
rs as a result of local tissue injury or abnormalities. Metastatic cal
cification results from abnormal calcium and/or phosphate metabolism.
Virtually any process that calcifies may secondarily ossify. Primary o
ssification may rarely occur.