Cutaneous calcinosis

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.

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.