You may have calcinosis cutis if you notice hard bumps on your skin or just beneath it. The bumps can be skin-colored or white and can feel hard or soft. Some might leak a white fluid.
Calcinosis refers to deposits of calcium in the body. This can happen in the skin, the tissue just below the skin, or your internal organs.
When calcinosis appears on or under the skin, it is called calcinosis cutis (or cutaneous calcification).
Initially, you may feel no symptoms. But you may have severe pain, ulceration, and infection.
What Causes Calcinosis Cutis?
Calcinosis cutis has many causes.
You may get it if any of these things have affected your skin:
- Trauma or injury
- Inflammation
- Varicose veins
- Tumors
- Infections
- Burns
You may also get it if you have any of these conditions, which can result in excess calcium deposits:
- Autoimmune connective tissue disease
- Systemic sclerosis or scleroderma
- Dematomyositis
- Lupus erythematosus
- Sjögren's syndrome
- Ehlers-Danlos syndrome
- Werner syndrome or progeria
- Rheumatoid arthritis
Types of Calcinosis Cutitis
There are five main types of calcinosis cutis depending on the cause.
Dystrophic
This is the most common type of calcinosis cutis. People with this type have normal phosphorus and calcium levels, but they have an underlying disease or injury that damages the skin. The dying cells release proteins that bind to phosphate and cause calcium deposits.
Metastatic
This type of calcinosis cutis is caused by high blood levels of calcium and phosphorus. This can be caused by systemic diseases, including:
- Chronic kidney disease
- Vitamin D poisoning
- Eating high amounts of calcium-rich foods
- Taking excessive amounts of antacids
- Sarcoidosis
- Hyperparathyroidism
Idiopathic
This type of calcinosis cutis doesn't have a clear cause. You get it even if you have normal calcium and phosphorus levels, no tissue or skin damage, and no autoimmune disease.
Idiopathic calcinosis cutis often shows up in teens and children. Some children are born with calcium bumps on their scalp and face.
Other examples of idiopathic calcinosis cutis:
- Familial tumoral calcinosis, or calcium tumors around the joints, in healthy teens
- Subepidermal calcified nodules, or white bumps on the scalp, face, and eyelids
- Scrotal calcinosis, or calcium nodules on the scrotum
Iatrogenic
Iatrogenic calcification happens when you are given a calcium phosphate drug or solution. This type of calcinosis cutis is usually an accidental outcome of a procedure or treatment. These can include:
- IV 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 of calcinosis cutis can happen in people with chronic kidney disease who are going through kidney dialysis. The blood vessels in the skin become hardened by calcium deposits.
What Are the Symptoms of Calcinosis Cutis?
Calcinosis cutis symptoms depend on what caused it.
Generally, calcinosis cutis looks like lesions or bumps on the skin. You may have one or many. You may not feel anything at first, or the bumps may be tender or painful and leak white fluid.
Your skin might get stiff. As the condition worsens, you may even develop gangrene.
If you have the bumps on your fingers, they may be especially painful. If you get them on a joint, they may limit the movement of the joint.
Depending on the type of calcinosis cutis, lesions can show up in different places on your body. Some of the most common places are:
- Around joints
- Butt
- Elbows
- Eyelids
- Face
- Fingers
- Forearms
- Knees
- Scalp
- Under lupus sores
While the 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
If you have lesions on your skin or around your joints, talk to your doctor to rule out calcinosis cutis.
How Is Calcinosis Cutis Diagnosed?
It is hard to diagnose calcinosis cutis because there are many types caused by different preexisting conditions.
If you think you have it, see your doctor or a dermatologist. Tell them if you have any of the conditions that might lead to a diagnosis.
Your doctor may order tests to check if you have higher levels of calcium and phosphate or if you have any metabolic issues.
Tests could include X-rays, a CT scan, or a bone scan.
Your doctor may also do a biopsy, taking a tissue sample from any lesions, bumps, or areas under your skin to test for calcium deposits and other abnormalities.
What's the Treatment for Calcinosis Cutis?
Treating calcinosis cutis depends in part on what type you have. Because there are no specific guidelines for treatment, each case is treated individually.
Your treatment team could include your doctor, a nephrologist (a kidney specialist), a rheumatologist (a specialist in musculoskeletal and autoimmune conditions), an endocrinologist (a specialist in hormone-related diseases), and a specialty care nurse.
Drugs and medications to treat calcinosis cutis include the following:
- Antibiotics, such as ceftriaxone and minocycline
- Biologic medicines
- Bisphosphonates
- Blood plasma therapy (intravenous immunoglobulin, or IVIG)
- Blood thinners, such as warfarin
- Calcium channel blockers, such as diltiazem
- Corticosteroids
- Kidney medications, such as probenecid
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Pain relievers
- Sodium thiosulfate (oral or topical)
In general, treatment depends on the extent of your calcinosis cutis.
Smaller lesions. You may be given drugs such as ceftriaxone, IVIG, or warfarin. Your doctor may also remove the lesions surgically or with a laser.
Larger lesions. You may be given drugs including aluminum hydroxide, bisphosphonates, diltiazem, or probenecid. A doctor may also remove the lesion via surgery or through curettage (scraping your skin with a special tool called a curette).
Your doctor might also suggest lifestyle changes that help raise blood flow in your body. They may suggest that you:
- 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
Some of the suggested medications may have side effects that make you sicker or cause more serious health issues, such as kidney problems.
Surgical or laser removal can also cause damage or injury to your skin, which can cause your lesions to grow back.
Other risks include slow wound healing and infection.
Sometimes, improper treatment for connective tissue autoimmune disease can lead to calcinosis cutis. To lower this risk, your doctor might suggest early, aggressive treatment with drugs that suppress your immune system.
Takeaways
- Calcinosis cutis is a condition in which calcium deposits build up in the skin or just below it.
- It causes bumps or lesions on your skin that can be hard or soft and may leak a white liquid.
- It can be symptom-free or result in severe pain, ulceration, infection, and reduced movement.
- There are several types of calcinosis cutis, depending on preexisting conditions you may have.
- Diagnosis is difficult and may require a team of professionals and testing of your skin, bones, and other organs.
- Treatments are also difficult and depend on the type and severity of your disease. A team of clinicians can help manage your treatment, which may involve several medications, surgeries, or other therapies.
FAQs About Calcinosis Cutis
Is calcinosis cutis an autoimmune disease?
It is a complication of several different autoimmune disorders, including lupus, Sjögren's syndrome, and rheumatoid arthritis.
What are the features of calcinosis cutis?
Calcinosis cutis is the buildup of calcium deposits on your skin or just beneath it, resulting in bumps or lesions.
What are the unique features of calcium in the body?
Calcium is the most abundant mineral in the body. Bones and teeth consist mainly of calcium. It's also in the circulatory system and other body tissues. It is important for muscle function, blood clotting, nerve signaling, and other body functions.
Is calcinosis cutis more prevalent in a specific gender?
It's difficult to say whether calcinosis cutis is more common in women or men because it results from several preexisting conditions that are more prevalent in one gender or another. One small study found more cases in men than in women, while another small study found the opposite.
