Idiopathic calcinosis cutis is one of the recognized subtypes of calcinosis cutis and is diagnosed when there is no underlying disease or iatrogenesis 1.
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Clinical presentation
Idiopathic calcinosis cutis may present as:
- tumoral calcinosis
- juxta-articular calcified lumps in otherwise healthy youngsters
- subepidermal calcified nodules
- calcified nodules in a subepidermal location in the head, hands and feet, primarily in children
On physical examination the foci of calcification are usually solitary, solid, pale yellow-white papules, ranging in size from 3-11 mm.
Locations
The commonest sites to find idiopathic calcinosis cutis are:
- scalp
- extremities
- joints
- scrotum
Other locations, such as the external nose, have rarely been reported 1.
Diagnosis
In order to make the diagnosis of idiopathic calcinosis cutis, one has to exclude any metabolic disorders, inherited conditions or other soft tissue diseases. Serum calcium will be normal, although phosphate is usually elevated 2.
Pathology
Histopathology
Markedly basophilic calcific foci subjacent to an acanthotic papillomatous epidermis are pathognomonic of idiopathic calcinosis cutis. The foci stain positive with the von Kossa calcium stain. A typical granulomatous reaction may also be seen.
Treatment and prognosis
For some no active treatment is necessary, however for others due to pain, secondary infections, concerns about the cosmetic effects or deleterious effects on function, surgical removal of the calcified papules is often performed 1.