Pharmacological treatment in calcinosis cutis associated with connective-tissue diseases.

Abstract

BACKGROUND:

Dystrophic calcinosis cutis is a common manifestation in connective tissue diseases, but there's still no consensus on treatment.

OBJECTIVES:

The purpose of this review is to discuss the current pharmacological options of treatment in calcinosis cutis related to rheumatic diseases.

METHOD:

We performed an extensive MEDLINE search of articles from 1970 to January 2014 using the index word "calcinosis" and the co-indexing terms "treatment", "calcium channel blocker", "diltiazem", "nifedipine", "verapamil", "amlodipine", "anticoagulant", "warfarin", "bisphosphonate", "etidronate", "pamidronate", "alendronate", "risedronate", "aluminum hydroxide", "probenecid", "antibiotic", "tetracycline", "minocycline", "ceftriaxone", "colchicine", "intravenous immunoglobulin", "sodium thiosulfate", "TNF-alpha inhibitors", "infliximab", "rituximab", "thalidomide", "corticosteroids", "stem cell transplantation".

RESULTS:

Diltiazem is recommended by some authors as first-line approach in calcinosis cutis and is also the therapeutic principal referred by the largest number of available publications. It seems to be efficient in more than half of the reported cases. There remain, however, a significant number of patients in which another solution must be found. The general trends observed over time are of switching the search of solutions in dystrophic calcinosis cutis related to connective tissue diseases, from therapies on calcium metabolism to therapies for the underlying disease. The new options available in the management of calcinosis cutis, like biological therapies or intravenous immunoglobulin, seem to be promising, but not universally successful. In children with severe forms, hematopoietic stem cell transplantation can also be taken into consideration.

CONCLUSIONS:

Data for all therapies proposed in calcinosis cutis is generally reported in single cases and small case series and so, the existent data is all yielding a low level of evidence.

• Authors: Alina Dima, P Balanescu, C Baicus
• Journal: Romanian journal of internal medicine = Revue roumaine de medecine interne (Rom J Intern Med) 2014 Apr-Jun Vol. 52 Issue 2 Pg. 55-67 ISSN: 1220-4749 [Print] Germany
• PMID: 25338341 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Anti-Bacterial Agents
• Anti-Inflammatory Agents
• Anticoagulants
• Biological Factors
• Calcium Channel Blockers
• Diphosphonates
• Immunoglobulins, Intravenous
• Immunologic Factors
• Thiosulfates
• Uricosuric Agents
• Thalidomide
• Aluminum Hydroxide
• sodium thiosulfate
• Probenecid

Topics

• Aluminum Hydroxide (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Anti-Inflammatory Agents (therapeutic use)
• Anticoagulants (therapeutic use)
• Biological Factors (therapeutic use)
• Calcinosis (complications, drug therapy, etiology)
• Calcium Channel Blockers (therapeutic use)
• Connective Tissue Diseases (complications)
• Diphosphonates (therapeutic use)
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Immunologic Factors (therapeutic use)
• Probenecid (therapeutic use)
• Skin Diseases (complications, drug therapy)
• Thalidomide (therapeutic use)
• Thiosulfates (therapeutic use)
• Uricosuric Agents (therapeutic use)