Answer to Image of the Month September 2013

Submitted by B Vijaya


Calcinosis cutis

Calcinosis cutis is deposition of calcium in the skin and subcutaneous tissues. It can be of varied forms such as, subepidermal calcified nodule, idiopathic scrotal calcinosis, auricular calcinosis, infantile calcinosis of the heel, milia like calcinosis and tumoral calcinosis.
Calcium deposits can be appreciated histopathologically on haematoxylin and eosin stains by their intense basophilia. However, sometimes calcium deposits may not be appreciated well and von Kossa stain will render the calcium deposits black. Transepidermal elimination is not an uncommon phenomenon in calcinosis cutis and is more commonly seen in subepidermal calcified nodule and milia-like calcinosis.
The present case showed minimal dermal tissue with deposits of calcium. The acanthotic epidermis shows perforating deposits of calcium which has been highlighted by von Kossa stain.

A clinical image of a different patient appears below.

calcinosiscutisPalmar calcinosis cutis in a child with dermatomyositis (Image courtesy: M Ramam)