Calcinosis
Calcium deposits that form firm lumps in skin and soft tissue
Quick Facts
- Type: Soft-tissue calcium deposition
- Common locations: Fingers, elbows, knees, near joints
- Often linked to: Scleroderma, dermatomyositis, lupus
- Key sign: Firm white or yellow lumps under skin
Overview
Calcinosis is the abnormal deposition of calcium salts in the skin (calcinosis cutis) or other soft tissues such as muscle and tendon. The deposits form firm, often whitish or yellow lumps that may be felt under the skin and can sometimes break through the surface, releasing a chalky material.
Calcinosis is not a single disease but a finding that can occur for several reasons. It is most often seen in association with certain autoimmune connective tissue diseases, but it can also follow tissue injury or develop when blood calcium and phosphate levels are abnormal.
Symptoms
The deposits themselves are the main feature, and symptoms depend on their size and location:
- Firm lumps or nodules under the skin, often white or yellowish
- Deposits most commonly on the fingertips, hands, elbows, knees, and over pressure points
- Tenderness or pain, especially when deposits are near joints or press on nerves
- Skin breakdown with leakage of a chalky, toothpaste-like material
- Ulcers that can become infected if the skin opens
Some deposits cause no symptoms and are noticed only as a lump, while others limit movement or cause recurring sores.
Causes
Calcinosis is grouped by its underlying mechanism:
- Dystrophic calcification: The most common type, where calcium deposits in damaged or inflamed tissue even though blood calcium levels are normal. This is typical of autoimmune diseases such as scleroderma and dermatomyositis.
- Metastatic calcification: Deposits form because blood levels of calcium or phosphate are too high, as can occur with kidney failure or overactive parathyroid glands.
- Idiopathic calcification: Deposits with no identifiable cause and normal blood levels.
- Iatrogenic and traumatic: Deposits that follow certain medical treatments or injury.
Risk Factors
- Autoimmune connective tissue diseases, especially systemic sclerosis (scleroderma) and dermatomyositis
- Lupus and related conditions
- Chronic kidney disease and disorders of calcium and phosphate balance
- Overactive parathyroid glands
- Long-standing tissue injury or inflammation
Diagnosis
Diagnosis combines examination of the lumps with tests to find the cause:
- Imaging: X-rays readily show calcium deposits; CT and ultrasound can map their extent.
- Blood tests: To check calcium, phosphate, kidney function, and parathyroid hormone, and to look for autoimmune disease.
- Biopsy: Occasionally used to confirm the deposits and exclude other diagnoses.
Identifying any underlying condition is central, because treatment of calcinosis often depends on it.
Treatment
There is no single reliably effective treatment, and management is individualized.
- Treating the underlying cause: Controlling the associated autoimmune disease, or correcting high calcium and phosphate levels, is the foundation of care.
- Medications: Various medicines are tried to slow deposit formation or ease symptoms, with results that vary from person to person.
- Local care: Painful, ulcerated, or infected deposits may need wound care and antibiotics.
- Procedures: Large, troublesome, or recurring deposits may be removed surgically or with other procedures, though they can recur.
Because calcinosis can be persistent, treatment focuses on relieving symptoms, preventing complications, and protecting function.
Prevention
- Work with your doctor to keep underlying autoimmune disease well controlled
- Manage calcium and phosphate balance in kidney disease as advised
- Protect affected skin from injury and pressure
- Care for any skin breaks promptly to prevent infection
When to See a Doctor
See a doctor if you develop firm lumps under the skin, especially over the fingers, elbows, or knees, or if you already have an autoimmune or kidney condition and notice new deposits. Seek prompt care if a deposit becomes painful, breaks through the skin, or shows signs of infection such as increasing redness, warmth, drainage, or fever.
Frequently Asked Questions
What is calcinosis?
Calcinosis is the buildup of calcium deposits in the skin or other soft tissues, forming firm lumps. It is a finding that can result from autoimmune disease, abnormal blood calcium or phosphate levels, or tissue injury, rather than a single disease.
Is calcinosis caused by too much calcium in the diet?
Usually not. The most common form, dystrophic calcification, occurs in damaged tissue even when blood calcium is normal. Some forms relate to high blood calcium or phosphate, but dietary calcium alone is rarely the cause.
Can calcinosis be cured?
There is no single cure that reliably removes all deposits. Treatment focuses on controlling the underlying condition, easing symptoms, and removing or treating troublesome deposits, which can sometimes recur.
Which diseases are linked to calcinosis?
It is most often associated with autoimmune connective tissue diseases such as scleroderma and dermatomyositis, and also with lupus, kidney failure, and overactive parathyroid glands.
When should I worry about a deposit?
See a doctor if a deposit becomes painful, opens through the skin, or shows signs of infection such as spreading redness, warmth, drainage, or fever, as it may need wound care or antibiotics.
References
- MedlinePlus, U.S. National Library of Medicine. Calcinosis cutis.
- Mayo Clinic. Scleroderma and CREST syndrome.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Scleroderma.
- Genetic and Rare Diseases Information Center (GARD). Calcinosis cutis.