What's the best approach for severe calcinosis cutis in a patient with dermatomyositis who is unresponsive to diltiazem and colchicine?  

Calcinosis cutis remains one of the most frustrating, typically recalcitrant manifestations of DM for both patients and physicians.Like Dr.@Christopher Morris, I also find that while there have been multiple case reports or small trials of various regimens published, the disappointing real-world var...

Two other medications have been used in the past; I have tried both on patients, and admit that neither have "wowed" me in terms of effectiveness. Topical sodium thiosulfate in zinc oxide base has been used in some older literature; I had a severe case, and she thought it might have helped some. Pro...

We also do topical and intralesional sodium thiosulfate. ChemistryRx in Philly will make the topical and ship anywhere. The smaller the deposit, the more effectively the topical works. I mix STS with lidocaine and it is dramatically better tolerated. We cannot get insurance to cover as above, so we ...

Intralesional sodium thiosulfate injection can be very effective for those with localized calcinosis though the injections are extremely painful, which limits their use. In our combined Derm-Rheum clinic, we have also found topical thiosulfate (compounded 25% cream) effective for small areas of supe...

I agree with the other physicians. There is no treatment available that tackles calcinosis cutis. If it is causing problems surgical removal is the best option.

While surgery is the best option for severe, symptomatic calcinosis cutis, this is not an endeavor for the faint of heart. There is a high likelihood of postoperative complications, especially the triggering of a prolonged foreign body reaction with serosanguineous drainage, inflammation and pain. W...