Medically Reviewed by Angela Chun, MD on February 9, 2026 and Belina Yi, DO on February 25, 2026. Cure JM shares medical resources to support informed conversations between families and their care teams.
At the October 25th (2024) Town Hall, Dr. Christian Lood, professor and researcher at the University of Washington and Seattle Children’s Hospital, presented on the topic of treating a potential complication of juvenile myositis known as calcinosis. Calcinosis is the accumulation of calcium phosphate crystals in soft tissue (skin, muscle). It appears as hard, irregular nodules (bumps) in or under the skin on various parts of the body. Up to 40% of children with JDM will develop calcinosis. Though many children may develop calcinosis, the problem remains that we know very little about why calcinosis forms.
What we do know is that it can be associated with certain autoantibodies, especially MDA5 and NXP2. We also know that delayed treatment, frequent trauma (physical use), or hypoxia can increase the risk of calcinosis. With more research needed on calcinosis, it can be difficult to treat, with treatment options being prescribed on a case-by-case basis.
Following Dr. Lood’s presentation, Dr. Adam Schiffenbauer presented detailed information on the current state of calcinosis management, potential treatments, and the importance of early intervention and aggressive treatment. Here is a detailed list of the medications and treatment measures discussed:
Anti-Inflammatory Therapies: Anti-inflammatory therapies involve treatments aimed at reducing inflammation in the body, which can help manage symptoms of JDM and calcinosis simultaneously.
Children may receive other anti-inflammatory treatments not listed below. Many medications used to manage JDM itself play an important role in controlling inflammation, which is critical for preventing and managing calcinosis.
- Intravenous immunoglobulin (IVIG)
- Infliximab, Brand name Remicade
- Colchicine, Brand name: Colcrys & Mitigare
- TNF-alpha inhibitors, including:
- Infliximab
- Adalimumab
- JAK Inhibitors:
- Tofacitinib
- Ruxolitinib (topical ointment option)
- Baricitinib
Medications targeting calcium/calcinosis itself: These medications are specifically used to treat the calcium nodules present in a child’s body and would be used in addition to a child’s JDM medication and treatments.
- Calcium Blockers: such as Diltiazem, Brand name: Cardizem CD and Taztia XT
- Bisphosphonates (pamidronate, etidronate, alendronate)
- Sodium Thiosulfate (IV form, Injection form, Topical ointment form)
Mechanical Measure: Mechanical measures would be taken as a last result and in more extreme cases of calcinosis.
- Cushioning/protection from microtrauma
- Surgical resection
A few key takeaways from both Dr. Lood and Dr. Schiffenbauer’s presentation is that many JDM children will develop calcinosis during their lives and that treatment must be done on a trial and effort basis. More importantly, early treatment of the JDM and calcinosis is most important for all children.
For additional information, please reference the following studies:
Aggressive management of juvenile dermatomyositis results in improved outcome and decreased incidence of calcinosis
A long-term study of children with juvenile dermatomyositis found that rapid diagnosis and early, aggressive treatment to fully control muscle inflammation significantly lowered the incidence of calcinosis. Children who developed calcinosis tended to have longer delays before diagnosis and treatment, longer periods of active inflammation, and longer overall disease duration. These findings highlight the importance of early recognition and prompt, comprehensive treatment of JDM.
Management of Calcinosis Cutis in Rheumatic Diseases
This review examines calcinosis across pediatric and adult rheumatic diseases, including dermatomyositis, and summarizes current understanding of how calcinosis develops. The authors note that while both nonpharmacologic and pharmacologic treatments have been explored, evidence remains limited and no single therapy is consistently effective. Management is often individualized, underscoring the need for further research into targeted treatments.
Treatment of calcinosis cutis in systemic sclerosis and dermatomyositis: A review of the literature
A systematic review of published studies evaluated available treatments for calcinosis cutis in dermatomyositis and systemic sclerosis. While high-quality evidence is limited, some therapies, including diltiazem, bisphosphonates, certain biologics, and intralesional sodium thiosulfate, have shown potential benefit in select patients. The authors emphasize that treatment decisions should consider both potential benefit and the strength of available evidence.
