Calcium and Other Mineral Deposition Disorders
Calcinosis cutis and other mineral deposition disorders are a group of dermatologic and metabolic conditions in which insoluble inorganic salts build up abnormally in the dermis, subcutis and connective tissue. The deposits are mostly calcium phosphate in the form of hydroxyapatite crystals, but can also be minerals such as iron, silver, gold or silicon.
These lesions can be disfiguring and painful and can cause chronic, slow-healing ulcers. They may also be a clue to serious autoimmune connective tissue diseases (such as systemic sclerosis or dermatomyositis) or to end-stage chronic kidney disease.
At Haute-Derma, we combine advanced imaging (high-frequency ultrasound and dermoscopy) with multimodal treatment (ablative lasers and medical therapy to regulate mineral metabolism) to treat calcified lesions effectively, restore the skin barrier and keep the underlying systemic disease under control.
Diagnosis and Systemic Screening at Haute-Derma
When we suspect a mineral deposit, Haute-Derma follows a standardized workup:
- Clinical Examination and Dermoscopy: we check how hard the lesion is (stone-hard). On dermoscopy, calcinosis shows ivory-white to creamy-yellow areas rimmed by dilated vessels, whereas argyria (silver deposition) shows uniform blue-gray pigment around the sweat duct openings.
- High-Frequency Ultrasound (HFUS, 20–50 MHz): shows the depth and nature of the deposit. Calcium appears as a strongly echogenic band with clear acoustic shadowing that blocks the signal behind it, which reliably separates it from a lipoma or fibroma.
- Blood Chemistry and Full Endocrine Assessment:
- Total and ionized calcium, phosphate and magnesium.
- Parathyroid hormone (PTH), 25-OH vitamin D and kidney function (eGFR, creatinine).
- An autoantibody panel (ANA, anti-Scl-70, anti-centromere, anti-Mi-2) to screen for autoimmune connective tissue disease.
- Biopsy and Special Stains:
- Von Kossa or Alizarin Red: stains calcium phosphate crystals black or deep red.
- Perls' Prussian blue: stains iron deposits (hemosiderin) deep blue.
Our Multi-Layered Treatment at Haute-Derma
Treating mineral deposition disorders means combining local mechanical or laser treatment with medical therapy that regulates mineral balance:
Systemic Medical Therapy
- Sodium thiosulfate (STS) to control calcium crystallization: STS binds calcium to form calcium thiosulfate, which is 250 times more soluble than calcium phosphate and can be excreted in the urine. It is given intravenously (especially in calciphylaxis) or applied topically / injected into lesions for calcinosis cutis.
- Calcium channel blocker (diltiazem): at high doses (240–480 mg/day) it reduces calcium influx into damaged cells and slows dystrophic calcification in scleroderma.
- Phosphate binders (sevelamer) and bisphosphonates: used in metastatic calcification due to kidney failure to lower the calcium × phosphate product.
Procedures and Skin Restoration at Haute-Derma
- Ablative UltraPulse CO2 laser / 2940 nm Er:YAG laser: precisely vaporizes the overlying epidermis layer by layer so the chalky calcium material can be removed, then promotes healing by secondary intention while limiting contracture scarring.
- Extracorporeal shockwave therapy (ESWT): acoustic shockwaves break hard calcium deposits under the skin into smaller micro-crystals that the body can more easily engulf and reabsorb.
- 1064 nm picosecond laser for silver (argyria) or iron (hemosiderin) deposits: ultra-short picosecond pulses create a photomechanical effect that shatters silver or hemosiderin particles around the basement membrane, so macrophages can clear them and gray, discolored skin becomes lighter.
- Surgical excision of large calcified masses: for large nodules that press on nerves or cause skin necrosis and ulceration around joints.
