Cutaneous calcinosis

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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

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.

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.