Diffuse cutaneous calculi (subepidermal calcified nodules): Case study

Abstract

Four forms of calcinosis cutis exist: metastatic calcinosis, dystrophic calcinosis, idiopathic calcinosis, and subepidermal calcified nodules, usually referred to as cutaneous calculi because single, small, raised, hard nodules are present. Occasionally, there are two or three nodules, and in some instances there are numerous or even innumerable nodules. Most patients are children, but in some patients, a nodule is present already at birth or does not appear until about adult life; in some instances, the surface of the nodule is verrucous, but it may be smooth. The most common location of the nodule is the face. A 12-year-old Yemeni child patient presented with warty, hard- and smooth-surface, white, and small and large non-itchy numerous nodules in the face and in the four extremities, which started at 4 years after birth, of 8 years' duration. Serum levels of calcium, phosphorous, and parathyroid hormones were normal. Plain chest X-ray, abdominal ultrasonography, and complete blood count picture were normal. Skin biopsy followed by histopathological examination was diagnostic. The patient was treated with curettage and surgical removal.