Topical sodium metabisulfite for the treatment of calcinosis cutis: a promising new therapy

Abstract

Calcinosis cutis is a chronic calcium-mediated disease that causes significant morbidity. Multiple treatments have been tried, with varying results; indeed, to date, no standard treatment has been generally accepted. Sodium metabisulfite is an inorganic compound that, when it reacts with oxygen, becomes sodium sulfate, a metabolite of sodium thiosulfate that has a similar ability to inhibit calcium oxalate agglomeration. Four women diagnosed with calcinosis cutis, secondary to dermatomyositis, systemic sclerosis and radiodermatitis after breast cancer, were evaluated for their response to topical 25% sodium metabisulfite. In all patients a decrease in lesion size, erythema and pain from injuries was shown, with complete resolution of the associated ulcers. One patient had a complete response. None experienced adverse effects. Topical sodium metabisulfite is a promising emerging therapy that should be considered as a valid alternative treatment in calcinosis cutis. Randomized prospective studies are required to evaluate its true efficacy.

Lack of response to intravenous sodium thiosulfate in three cases of extensive connective tissue disease-associated calcinosis cutis

“…While previous reports have demonstrated benefit from topical and intralesional STS in dystrophic calcinosis cutis, those cases all involved small, focal lesions, whereas the patients presented here had extensive or plate-like calcinosis. 4,5 It is likely that the extent of calcinosis and duration of disease impact the treatment results. Furthermore, a longer course of therapy may have been more effective by allowing soluble calcium thiosulfate products to form and be removed over time.…”

“…1 Sodium thiosulfate (STS), an antioxidant and chelator of cations, may increase calcium solubility when it combines with cations. 2 Intravenous, 2 intralesional 3 and topical STS have been successfully used to treat calciphylaxis, while topical and intralesional 4 STS, as well as topical sodium metabisulfite, 5 have been reported as effective in several cases of localized calcinosis cutis. We report our experience with the use of intravenous (IV) STS for dystrophic calcinosis cutis associated with CTD.…”

Topical Sodium Thiosulfate: A Treatment for Calcifications in Hyperphosphatemic Familial Tumoral Calcinosis?

“…For example, relief of pain is regularly reported in published cases after only a few days of treatment (20). Improvement of local perfusion secondary to local vasodilatation has been reported independently of calcium chelation (21). These effects are probably due to other chemical effects of STS, such as H 2 S production, NO synthase regeneration or a free radical scavenging effect (10).…”

Кальциноз При Системній Склеродермії: Поширеність, Клініка, Менеджмент, Ускладнення

“…Four patients with calcinosis (two with SSc, two with DM) had a significant reduction of size, erythema and pains with topical application of 25 % Sodium metabisulfite (SM), STS's metabolite. Researchers suggest that topical SM may dissolve calcium deposits and promote local vasodilation and wound healing [47]. J. Goossens et al report two cases of STS being used as daily intrafocal injections in a dose of 1-3 g, which led to pain relief, improvement of function and a two-fold diminishing of focal size after 12 months of therapy [48].…”