Summary of mechanism of action of therapeutics used to treat calcinosis cutis.
| Treatment | Rationale |
|---|---|
| Warfarin | Warfarin antagonizes vitamin K and therefore reduces the levels of MGP by preventing carboxylation of glutamic acid |
| Diltiazem | Decrease in the influx of calcium ions into cells leading to correction of an abnormal imbalance of intracellular calcium concentration that may lead to crystal formation |
| Rituximab | Anti-CD20 antibody that depletes B lymphocytes |
| Bisphosphonates | Inhibit macrophage proinflammatory cytokine production and reduce calcium turnover |
| Sodium thiosulfate | Potent antioxidant and vasodilator that also chelates and dissolves calcium deposits |
| IVIG | Through decreasing inflammation, possibly through inhibition of macrophage function |
| Minocycline | Tetracycline antibiotic with antiinflammatory and calcium-binding properties |
| Colchicine | Antiinflammatory effect by disrupting leukocyte chemotaxis and phagocytosis through inhibiting microtubule polymerization |
IVIG: intravenous Ig; MGP: matrix gamma-carboxyglutamic acid protein.