Calcinosis cutis is a condition where calcium salts are deposited in your skin. It can happen for a variety of reasons, and it often presents differently in different cases.
About Calcinosis Cutis
Calcinosis cutis happens when calcium gathers in your skin, muscles, tendons, connective tissue, and subcutaneous tissue — the innermost layer of your skin that contains fat. There are five types of calcinosis cutis, including:
- Dystrophic
- Metastatic
- Idiopathic
- Iatrogenic
- Calciphylaxis
Dystrophic. This is the most common cause of calcinosis cutis. People who have this type have normal phosphorus and calcium levels, but have an underlying disease or injury that damages the skin. The dying cells release proteins that bind phosphate and cause calcium deposits. These underlying diseases include:
- Mixed connective tissue disease (MCTD)
- Lupus
- Systemic sclerosis, or scleroderma
- Dermatomyositis
- Sjogren syndrome
- Ehlers-Danlos
- Werner syndrome
- Rheumatoid arthritis
- Injury
- Burns
Metastatic. This type is caused by high blood levels of calcium and phosphorus. This can be caused by:
- Chronic kidney disease
- Vitamin D poisoning
- Eating high amounts of calcium-rich foods
- Taking excessive amounts of antacids
- Sarcoidosis
- Hyperparathyroidism
Idiopathic. This type doesn’t have a clear cause. In this condition, you might have normal calcium and phosphorus levels, no tissue or skin damage, and no autoimmune disease. Some specific conditions fall in this type, including:
- Familial tumoral calcinosis (calcium tumors around the joints) in healthy teens
- Subepidermal calcified nodules (white bumps on the scalp, face, and eyelids)
- Scrotal calcinosis (calcium nodules on the scrotum)
Idiopathic calcinosis cutis often shows up in teenagers and children. Some children are born with these bumps on their scalp and face.
Iatrogenic. Iatrogenic calcification happens when you are given a calcium phosphate drug or solution. This is usually an accidental outcome of a procedure or treatment. These can include:
- Intravenous calcium chloride or calcium gluconate for tuberculosis treatment
- Contact with calcium chloride paste in tests that use electrodes
- Organ transplant
- Solutions that have calcium or phosphate
Calciphylaxis. This type happens in kidney dialysis and chronic kidney disease. The blood vessels in the skin become hardened by calcium deposits.
Calcinosis can also be caused by infections.
Symptoms of Calcinosis Cutis
Calcinosis cutis usually looks like lumps on the skin. These can come slowly over time and have no other symptoms or they can come suddenly and be severe. They can be skin-colored or white and hard or soft. Some might leak a white fluid and be very painful.
Depending on the type of calcinosis cutis, these lesions can show up in different places on your body. Some of the most common places are:
- Elbows
- Fingers
- Knees
- Forearms
- Butt
- Under lupus sores
- Around joints
- Face
- Scalp
- Eyelids
While these lesions might not have symptoms, sometimes they can cause other problems, including:
- Trouble walking or moving
- Disability
- Skin ulcers
- Muscle or tendon rigidity
- Joint deformity
- Loss of movement
- Pain
Calcinosis Cutis Treatment
The reason why you get calcinosis cutis isn’t well-understood yet, so treating this condition can be hard. Your doctor might give you medicine or use surgery treatments, including:
- Blood thinners, like warfarin
- Antibiotics, like ceftriaxone and minocycline
- Blood plasma therapy ( intravenous immunoglobin)
- Calcium channel blockers, like diltiazem
- Bisphosphonates
- Kidney medications, like probenecid
- Antacids, like aluminum hydroxide
- Topical sodium thiosulfate
- Pain relievers
- Corticosteroids
- Non-steroidal anti-inflammatory drugs
- Biologic medicines
- Surgery removal
- Carbon dioxide laser removal
These treatments will depend on the type of calcinosis cutis you have and some of your symptoms. Small lesions that tend to be in one area might be treated with surgery or laser, but lesions that affect your whole system might need medicines.
Your doctor might also suggest lifestyle changes that help raise blood flow in your body, including:
- Stop smoking.
- Lower your stress.
- Limit your exposure to cold.
- Protect your skin from the sun.
- Avoid injury or damage to the skin.
Sometimes calcinosis cutis can also clear up on its own without any treatment.
Risks of Calcinosis Cutis and Treatment
Calcinosis cutis can lead to problems with:
- Joints
- Deformities
- Swelling
- Infection
- Skin ulcers
- Pain
Some of the suggested medications might have side effects that make you more sick or cause more serious health problems like kidney problems.
Using surgery removal or laser removal also can damage or cause injury to the skin. This can cause your lesions to grow back. Other risks include slow wound healing and infection.
Calcinosis cutis can be hard to manage and treat because there isn’t one treatment that works for everyone. Individual approaches have to be used.
Sometimes improper treatment for connective tissue autoimmune disease can lead to calcinosis cutis. Your doctor might suggest that you have early, aggressive treatment with drugs that suppress your immune system to lower this risk.
If you have lesions on your skin or around your joints, talk to your doctor to rule out calcinosis cutis.
