This article explains the symptoms, causes, and diagnosis of calcinosis cutis as well as the current options for treatment.
Symptoms
Calcinosis cutis causes small, hard, white or yellowish lumps under the skin. The lumps can vary in size and often appear in clusters. They are generally slow-growing and often start with redness or itching of the skin. Even so, most people have no symptoms before the lumps appear.
Calcinosis cutis can occur anywhere on the body but is most common on the fingertips, around the elbows or knees, or on the shins. Other frequent sites include the face and scrotum.
The lesions usually cause no pain but can be upsetting if they appear on the face. In rare cases, calcium can build up within joints where it can cause pain. If lesions break open or are punctured, a pasty substance may drain out.
Causes
Calcium and phosphate are minerals that the body needs to function. They are involved in building bones, maintaining heart rhythm, and other key functions.
Calcinosis cutis is caused either by abnormally high levels of calcium or phosphate in the body or when tissue damage causes the body to release proteins that bind calcium in clumps.
There are several types of calcinosis cutis:
Dysmorphic calcinosis cutis occurs when damaged tissues release proteins that bind calcium and phosphate, creating clumps that gradually increase in size. Causes include autoimmune diseases like lupus, rheumatoid arthritis, and scleroderma as well as acne, skin infections, varicose veins, and burns. Iatrogenic calcinosis cutis is caused by the excessive intake or absorption of calcium. This is often related to substances like intravenous (IV) calcium used to treat tuberculosis or calcium chloride paste used on electrodes for brain scans. Metastatic calcium cutis occurs when calcium or phosphate levels are high but there is no tissue damage. When phosphate levels are high, they naturally bind to calcium. Causes include cancer, chronic kidney disease, hyperparathyroidism, and sarcoidosis. Idiopathic calcium cutis occurs when calcium and phosphate levels are normal and no cause is found.
Diagnosis
The diagnosis of calcinosis cutis starts with an examination of the skin and a review of your medical history. Blood tests will be ordered to see if your calcium or phosphate levels are high.
The doctor may order other blood tests to see if an underlying disease is involved. The tests may include:
Renal function tests to check for kidney disease Parathyroid hormone level to check for hyperparathyroidism C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) to check for inflammation, such as can occur with autoimmune diseases
Imaging studies, including computed tomography (CT) scans and bone scans, can be used to determine the extent of the calcium deposits.
Because calcinosis cutis can be confused for other things, like milia (whiteheads) and gouty tophi (skin growths caused by gout), a biopsy can be ordered to confirm the diagnosis and exclude other causes.
Treatment
Because there are many different causes for calcinosis cutis, there are many possible treatments. That said, treatment may not be needed if the deposits are not causing discomfort or distress.
Calcium channel blockers, like Cardizem (diltiazem), Norvasc (amlodipine), and Verelan (verapamil), are among the first-line drugs used to treat calcium deposits. They work by lowering the amount of calcium that can be taken up by skin cells.
The steroid drug prednisone and anti-inflammatory drug Colcrys (colchicine) can reduce inflammation and shrink calcium deposits. The blood thinner Coumadin (warfarin) has similar effects.
If needed or desired, the lesions can be removed or reduced in several ways, including:
Surgical excision, involving a scalpel Laser therapy, using light or carbon dioxide laser Iontophoresis, which delivers calcium-dissolving medications through the skin using electrical currents
To get the best long-term results, the doctor will need to treat the root cause.
Summary
Calcinosis cutis is the deposit of calcium under the skin that causes firm, whitish or yellowish bumps. It can be caused either when the level of calcium or phosphate in the body is high or when skin trauma causes the body to release proteins that bind calcium into clumps.
The diagnosis may involve a physical exam, blood tests, imaging studies, and a biopsy. If needed, calcinosis cutis can be treated with drugs like calcium channel blockers, prednisone, or colchicine. The lesions can be removed with surgery, lasers, or other procedures.
A Word From Verywell
White bumps on the skin can be upsetting but are especially so when they appear on an area as obvious as the face. Don’t assume that any white bump on the face is a calcium deposit, though. There are other skin conditions that may be far more serious.
If you have any unusual bump on the skin, have it checked out by your doctor. If needed, you can be referred to a skin specialist known as a dermatologist for further evaluation.
