Calcinosis and Scleroderma
Calcinosis is the abnormal collection of calcium salts which form under the skin and in muscles or tendons. This scleroderma complication can develop slowly over time and have no other symptoms, or can come on suddenly and be severe.
Calcinosis appears as hard, irregular nodules in or under the skin in any area of the body. These deposits vary in size and shape, ranging from a tiny speck, pea-sized, to larger tumorous deposits located most commonly in the fat pad of the fingertips, as well as on the hands, arms, elbows, knees, and trunk. They can also break the surface of the skin, becoming a lesion and can be skin-colored or white, hard or soft. Some might leak a white fluid and in severe cases can be very painful and limit range of motion.
Treatments for Calcinosis
Treatment of calcinosis from scleroderma can be challenging. There is no treatment that is effective for everyone and few medications or treatments are effective against calcinosis.
Increasing blood flow to the extremities, through smoking cessation, decreasing stress, and limiting exposure to cold, may be helpful. Appropriate sun-protection is always important since sun exposure can stimulate the immune system, which may contribute to calcinosis.
Lesions may respond to the following medications:
- Antacids can reduce risk by helping to prevent the absorption of phosphate
- Bisphosphonates help hinder bone turnover and lower calcium and phosphate levels
- Calcium channel-blockers can diminish the concentration of intracellular calcium
Surgical excision may be used to remove smaller lesions that are confined to a single area, especially those in painful or troubling areas of the body. Unfortunately, there is always a risk that the lesions will return. Calcinosis occasionally clears on its own with no intervention.