By Gary M. White, MD
Note: this is only a brief summary of sodium thiosulfate (STS) and focuses on its use in dermatology. Anyone interested in using STS should seek out other sources before prescribing.
Sodium thiosulfate (STS) is a powerful antioxidant and chelating agent, which has been traditionally used for cyanide poisoning and cisplatin toxicity. In dermatology, it has been used increasingly for calciphylaxis and more recently for calcinosis cutis. The proposed mechanism of action includes increasing calcium solubility. It has been given intravenously, intralesionally and topically.
Potential side effects of intravenous STS include nausea, metabolic acidosis, hypotension and volume overload. Few side effects have been reported with intralesional STS.