Cutaneous calcinosis

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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.[1]

Subtypes:[2]

  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

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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

References

  1. Dubey, S.; Sharma, R.; Maheshwari, V. (2010). "Scrotal calcinosis: idiopathic or dystrophic?". Dermatol Online J 16 (2): 5. PMID 20178701.
  2. URL: http://emedicine.medscape.com/article/1103137-overview. Accessed on: 21 September 2011.