Calcinosis cutis refers to deposits of calcium in the skin and subcutaneous tissue.It is commonly associated with pain, reduced mobility, and chronic infections. 

Studies on the feasibility and efficacy of alternative therapies to systemic treatment and surgical excision are rare. These are important as traditional therapies are often associated with unsatisfactory results or complications. 

A study thus investigated the efficacy and safety of topical and intralesional sodium thiosulfate, extracorporeal shock-wave lithotripsy (ESWL), and laser for calcinosis cutis by searching PubMed, Embase, and Web of Science for the relevant studies. 

The observations of the study were as follows-

• 40 studies with 136 patients were analyzed.
• 64% to 81% of cases demonstrated Partial or complete remission after monotherapy
• The patient’s adherence was important for Self-applied topical sodium thiosulfate
• The mean treatment duration for Self-applied topical sodium thiosulfate was 4.9 months (range 2–24).
• Complete remission of microcalcifications was observed after a single procedure of Laser therapy.
• Calcinosis-associated pain was seen to be decreased after ESWL and intralesional sodium thiosulfate injections.
• Scarring and hyperkeratosis were the commonest side effects following CO2 laser.
• Intralesional sodium thiosulfate injections were associated with transient pain in about 11% of patients.
• Follow-up showed rare recurrences. 

Thus the effectiveness of the minimally invasive and local therapies, in selected cases, was demonstrated in this study. Further, these alternative therapies might excel the conventional treatment. 

Nowaczyk J, Zawistowski M, Fiedor P. Local, non-systemic, and minimally invasive therapies for calcinosis cutis: a systematic review. Arch Dermatol Res, 2021. https://doi.org/10.1007/s00403-021-02264-5