Pathology of Calcinosis Cutis
Calcinosis cutis, the deposition of calcium in the dermis can be
dystrophic, metastatic, iatrogenic, or idiopathic.
[ Microscopic images showing large irregular deposits in a dense collagenous stroma. Calcium salts are easily identified by hematoxylin and eosin by intense uniform basophilia. (von Kossa silver stain is used to confirm the diagnosis). This stain blackens the deposits.]
The following are some important conditions characterized by deposition of calcium in the dermis:
-Subepidermal Calcified Nodule:
These are solitary lesions.
Site: Head, ear, extremities.
Age: Usually young children ; sometimes in adults.
-Idiopathic Scrotal Calcinosis:
Rare benign condition.
Site: Scrotal skin.
Age: Children or young adults.
Clinical presentation: Present as single or multiple hard, yellowish asymptomatic nodules.
These lesions increase in size and number and sometimes break down to discharge chalky material.
- Tumoral Calcinosis:
Idiopathic condition. Characterized by large deposits of calcium in the subcutis. Located on large joints.
- Dystrophic Calcification:
Dystrophic calcification is the most common type of calcinosis cutis and is associated with a variety of diseases.
It usually occurs in connective tissue diseases.
- Metastatic Calcification:
Patients may have hypercalcemia with primary or secondary hyperparathyroidism.
Deposits are noted in the deep dermis or subcutaneous tissue.
Common sites: Axillae, abdomen, medial part of thigh.
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