What is Calcinosis?

Calcinosis is the development of hard calcium deposits that form on the skin or in the body. Four main forms exist. These are dystrophic, metastatic, iatrogenic, and idiopathic.

Dystrophic calcinosis occurs most frequently. In this type, people do not have a higher than normal level of calcium or phosphate in their blood. Calcification tends to occur around the site of a recent surgery or wound. Simple acne or minor cuts may cause this type, which usually occurs in the presence of damaged skin or other soft tissues.

Tissue damage from autoimmune disorders like lupus, rheumatoid arthritis, or scleroderma can result in calcinosis around the damaged areas. Joint injury or the presence of tumors can also cause damaged tissue to form calcium-based lesions.
With dystrophic calcinosis, the lumps formed by calcium are usually localized to the specific area of tissue damage. However, some autoimmune disorders that result in damage to soft tissues in multiple areas may mean more formation of lumps.

When possible, surgical removal of the lumps may be helpful, but they may recur if they are the result of disorders that continually damage the soft tissues of the body. Additionally, surgery itself may result in more deposits. Treatment usually focuses on addressing underlying conditions to reduce soft-tissue damage.

Metastatic calcinosis is caused by the presence of too much calcium and/or phosphate in a person’s blood. As a result, calcium deposits tend to build quickly and readily in several different areas of the body.

The main cause of this type is failure of the kidneys, which are unable to rid the body of excess calcium and phosphates. Overstimulation of the thyroid gland can create too much calcium and phosphates in the blood as well. Ingestion of too much vitamin D may be a causal factor. Also, diseases that destroy bone tissue, like Pagets Disease or various bone cancers can cause metastatic calcinosis.

Treatment is difficult in many of these cases. Underlying causes for an excess of calcium or phosphate may be addressed. Some doctors address the presence of too much calcium by administering antacids like aluminum carbonate, which can remove some of the calcium in the intestines. Others use calcium blockers like warfarin, but this medication requires intense follow-up to rule out excessive bleeding.

Idiopathic calcinosis may arise in children who are born with birth defects of the soft tissues. They are common in areas like the scrotum and vagina. As well, single idiopathic calcium lesions may form on the face. Some diseases, like Downs syndrome, make one more vulnerable to calcium lesions. Lesions can form at the site of organ transplants. Treatment goals follow procedures above, but may not be entirely effective.
Iatrogenic calcinosis is usually localized to a single site where tissues have been damaged through surgery. Children, who undergo frequent heel sticks to withdraw blood, may develop calcium deposits on their heels. Electrode paste, which contains calcium, and may be used to evaluate brain activity, can cause it when the electrodes are used for too long.

Any type of calcinosis is difficult to treat. Usually, the condition is not painful, though large lesions around organs can cause pain. Clearly more research into the underlying conditions that cause these lesions may help reduce the incidence of deposits.