Cutaneous calcinosis

Cutaneous calcinosis, also calcinosis cutis and cutaneous calcification, is calcification of the skin. It is benign in itself; however, the underlying cause may not be.

Cutaneous calcinosis
Diagnosis in short
Cutaneous calcinosis. H&E stain.
Synonyms	cutaneous calcification, calcinosis cutis
LM	dermal calcification - usu. well-circumscribed
Gross	firm nodule
Site	skin, scrotum
Clinical history	+/-trauma at the site
Signs	firm nodule
Prevalence	uncommon
Prognosis	benign
Treatment	excision

General

• Benign in itself; underlying cause may not be benign.
• May be a scrotal lesion - known as scrotal calcinosis.

Subtypes:

1. Dystrophic - due to death of cells; may be related to a tumour.
2. Metastatic - due to chronic renal failure; hyperkalemia; paraneoplastic phenomenon.
3. Iatrogenic - post surgical.
4. Idiopathic.

Gross

• Firm nodule.

Microscopic

Features:

• Dermal calcification:
  • Acellular purple blobs on H&E.
    • +/-Artefactual tearing of surrounding tissue due to processing (cutting).
    • +/-Small artefactual lines ~1-2 micrometers due to processing (cutting).
    • +/-Greyish rim of paucicellular material.
  • Usu. well-circumscribed.
    • May be surrounded by a palisading granuloma & giant cells.

Images

• 

  CC - very low mag.

• 

  CC - low mag.

• 

  CC - intermed. mag.

www:

• Calcinosis cutis (dermatopathonline.com).

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SKIN AND SUBCUTANEOUS LESION, LEFT HIP, EXCISION:
- SUBCUTANEOUS CALCIFICATION SURROUNDED BY BENIGN FIBROUS TISSUE.
- DERMAL SCAR.
- NEGATIVE FOR MALIGNANCY.

SUBCUTANEOUS MASS, OVER BURSA OF ELBOW, EXCISION:
- CALCINOSIS CUTIS.

Micro

The sections show calcifications surrounded by macrophages and giant cells. No nuclear atypia is apparent. The overlying epidermis is unremarkable.

Without epidermis

The sections show dermal/subcutaneous calcifications surrounded by fibrosis, macrophages and giant cells. No nuclear atypia is apparent. Overlying epidermis is absent.

See also

• Non-malignant skin disease.
• Heterotopic ossification.