Case Of Idiopathic Calcinosis Cutis Research Articles

Calcinosis Cutis of the Nasal Dorsum

Summary:Calcinosis cutis is a common dermatological problem in patients with systemic sclerosis, dermatomyositis, and systemic lupus erythematous; however, it is rare to occur outside of these diseases. It represents a multidisciplinary problem that involves primary care physicians, dermatologists, and surgeons. The pathophysiology is defined by deposition of calcium salts in the subcutaneous tissue as hydroxyapatite, but the underlying mechanism has yet to be determined. The most common locations of lesions are the scalp, scrotum, extremities, and joints. Rarely does calcinosis cutis occur on the face. We present a unique case of idiopathic calcinosis cutis that occurred in a healthy patient with normal serum calcium and phosphate levels on the nasal dorsum, which was managed surgically. The histology of the calcinosis showed normal morphology, dominated by large deposits of calcium and normal surrounding tissues. This case represents a rare but clinically relevant presentation of idiopathic calcinosis cutis in an otherwise healthy individual.

Idiopathic calcinosis cutis of the right iliac region: Common lesion at uncommon

Calcinosis cutis is an uncommon soft tissue lesion characterized by the deposition of calcium salts in the skin or subcutaneous tissue attributed to a wide variety of causes. We present a case of idiopathic calcinosis cutis in an adult male, who presented with a swelling in the right iliac region. Chalky white aspirate and amorphous basophilic granular material on microscopy suggestive of calcium deposits were noted. Histopathological examination of the excised mass coupled with appropriate clinical background led to the final diagnosis of idiopathic calcinosis cutis. We present this case with a complete diagnostic workup to undermine the importance of considering this lesion in the differential diagnoses of a subcutaneous hard lump in an otherwise healthy patient.

Idiopathic calcinosis cutis of the scrotum: a case report and review of the literature

BackgroundAbnormal deposition of calcium in the skin or subcutaneous tissue is termed calcinosis cutis. Idiopathic calcinosis cutis of the scrotum is an uncommon entity. The pathogenesis of idiopathic calcinosis cutis of the scrotum is debatable. The condition presents as several brown to yellowish nodules on the scrotum, gradually progressive, and mostly asymptomatic. Here we report a case of idiopathic calcinosis cutis of the scrotum with a brief review of the literature and a discussion on pathogenesis.Case presentationA healthy looking, 50-year-old Nepali man presented with multiple growths on his scrotum for 15 years, which were mostly asymptomatic with an occasional complaint of itching. On physical examination, multiple pink to brown nodules ranging in size from 0.5 × 0.5 × 0.5 cm to 3 × 3 × 1 cm, which were painless and firm in consistency, were noted. On laboratory examinations the following were found to be within normal limits: serum calcium, phosphorus, parathyroid hormone, and vitamin D hormone levels; uric acid; alkaline phosphatase; and lipid profile. Based on clinical features and laboratory reports, a diagnosis of idiopathic calcinosis cutis of the scrotum was made. The nodules were excised under local anesthesia in several sittings, which gave a good cosmetic result with no evidence of recurrence in 1-year follow-up period. A histopathological examination revealed dermis with areas of fibrosis and calcification along with numerous multinucleated giant cells and an absence of any cystic structure.ConclusionsIdiopathic calcinosis cutis of the scrotum is a benign condition, which remains mostly asymptomatic. It presents as progressive multiple nodules of varying numbers and sizes. A histopathological evaluation reveals areas of calcification. The cause is either dystrophic calcification of cysts or idiopathic. Excision is the treatment of choice.

FNAC of Bilateral Iliac Idiopathic Calcinosis Cutis: A Rare Case Report

We report a case of idiopathic calcinosis cutis diagnosed by fine needle aspiration cytology in a 70 year old female who presented with subcutaneous swellings near the bilateral iliac crests. Cytological finding of amorphous calcium salts with histiocytes and the appropriate clinical background led to the cytodiagnosis of idiopathic calcinosis cutis as subsequently confirmed on histopathology. Pitfalls in the diagnosis of calcinosis cutis on cytology smears are also discussed

Idiopathic Calcinosis Cutis of Scrotum

A 45 year old male presented with multiple, painless, hard nodular swelling over scrotum of two years duration. The nodules gradually increased in size. There was no history of trauma or any systemic illness. A provisional diagnosis of sebaceous cyst of scrotum was made. His haematological and biochemical parameters were normal. En-block excision of lesion was done. Histopathological diagnosis of calcinosis cutis was made and confirmed by Von Kossa stain. We report herewith a case of idiopathic calcinosis cutis of scrotum and review the literature regarding pathogenesis and management.

Idiopathic Calcinosis Cutis over Elbow in a 12-Year Old Child

Calcinosis cutis is an uncommon disorder caused by an abnormal deposit of calcium phosphate in the skin in various parts of the body. Four main types of calcinosis cutis have been recognized according to etiology: associated with localized or widespread tissue changes or damage (dystrophic calcification), that associated with an abnormal calcium and phosphorus metabolism (metastatic calcification), not associated with any tissue damage or demonstrable metabolic disorder (idiopathic calcification), and Iatrogenic. Very few cases of idiopathic calcinosis cutis are reported in early childhood in the literature. We report one such case of idiopathic calcinosis cutis over elbow in a 12-year-old female child. Histological examinations of the lesions resected in this case reveal calcium deposits in the dermis, surrounded by foreign body giant cells. Idiopathic calcinosis cutis is a rare phenomenon and occurs in the absence of known tissue injury or systemic metabolic defect. It is important to delineate it from other calcification disorders for further plan of management. Medical therapy in calcinosis cutis is of limited benefit in pediatric age group and poses a challenging problem of postsurgical management.

Idiopathic vulvar calcinosis: The counterpart of idiopathic scrotal calcinosis

Calcinosis cutis is characterized by the deposition of hydroxyapatite crystals of calcium phosphate in the skin. It is commonly encountered as a consequence of connective tissue disease or metabolic abnormalities but sometimes could be idiopathic. We report a case of idiopathic calcinosis cutis of the vulva in a healthy woman. A 35-year-old woman presented with multiple asymptomatic yellowish nodules on the external genitalia of one year duration. A few of the nodules broke down spontaneously discharging a chalky white material. She was otherwise healthy and had no systemic complaints. There was neither a history of trauma nor any inflammatory process in the vulvar skin prior to the development of lesions. The hematologic and biochemistry panel such as liver and renal function, serum calcium, phosphorous, electrolytes, uric acid and parathyroid hormone levels were normal. An excision biopsy of the nodule showed features suggestive of calcinosis cutis (Fig. 1). Fig. 1 10× photomicrograph showing the amorphous calcific deposits in the dermis Cutaneous calcification may be divided into four major categories: dystrophic, metastatic, iatrogenic and idiopathic.1 Though dystrophic calcinosis is fairly common, idiopathic calcification is rare, and usually no underlying cutaneous cause can be identified. It commonly presents as painless, firm papules and nodules that appear in childhood and adolescence and gradually increase in number and size. Lesions may be solitary or pedunculated and are initially skin-colored, but as they grow larger they become yellowish and lobulated breaking down spontaneously or when compressed to produce a chalky white material. Microscopic examination typically shows large granular deposits of deeply basophilic material which stains black with Von Kossa stain for calcium.2 The pathogenesis of idiopathic vulvar calcinosis is highly disputed. The principle debate concerning the cause is whether calcium is deposited at the site of inflamed epidermal cysts or whether the calcific nodules are truly idiopathic. Although several authors have suggested that vulvar calcinosis results from dystrophic calcification of the inflammed epidermal cysts, several others have refuted the above facts and found it to be truly idiopathic.3 Idiopathic calcinosis cutis of the vulva is rare with only seven cases reported worldwide. Besides, it has also been reported over the neck after rhytidectomy,4 the sctotal wall5, shaft of the penis6 and the areola of the breast.7 Cornelius et al, have postulated that tiny apatite crystals seen only on electron microscopy in cases of idiopathic calcinosis cutis might act as a source of injury leading to secondary deposition of acid mucopolysaccharides, which become a matrix for crystal formation and calcification. What initiates the deposition of these crystals is not yet known.8 In our case no predisposing cause for calcification could be identified and since the patient was asymptomatic and not keen on surgical removal the lesions were not excised.

IDIOPATHIC CALCINOSIS CUTIS IN FINGERTIP TREATED WITH OCCLUSIVE DRESSING USING ALUMINUM FOIL: A CASE REPORT

Calcium deposition in the skin, known as calcinosis cutis, is an uncommon disorder caused by an abnormal deposit of calcium phosphate in the skin. We report a case of idiopathic calcinosis cutis in fingertip treated with surgical excision followed by the occlusive dressing using aluminum foil, and obtained significant pain relief and round-shaped fingertip which looked normal.

Milialike Idiopathic Calcinosis Cutis in Down's Syndrome

To the Editor.— We present what we believe to be the first reported case of idiopathic calcinosis cutis in Down's syndrome. Report of a Case.— A 6-year-old boy with documented trisomy 21 was first seen in April 1987 for whitish papules on the hands, feet, legs, and face (Fig 1) of 2 year's duration. The lesions appeared initially on the left hand at the border of a previous thermal burn. Diagnosis of milia was made at that time. However, lesions began to appear on nonburned skin and rapidly increased in number. The lesions have always been asymptomatic. On examination there were dozens of discrete whitish 1- to 3-mm, round, firm papules grouped over the dorsum of the hands, wrists, elbows, knees, and face. There was no evidence of previous trauma or inflammation in the involved area other than the healed burn scar on the left hand. Three separate skin biopsy