A rare case of extensive idiopathic scrotal calcinosis

Abstract

Background: Bisphosphonates are common drugs used for the treatment of postmenopausal osteoporosis. Short term benefits of the bisphosphonates are well known. However, there are concerns regarding their long term use. Objectives: The aim of the study was to analyze the association between bisphosphonate treatment and atypical femoral fractures. Material and methods: The records of nine patients from a tertiary care hospital in Bhopal were reviewed for evaluating the association between bisphosphonate use and atypical femoral fractures. The retrospective analysis was done for the indications, duration of bisphosphonate use, and configuration of associated fractures, management and outcome of the fractures. Results: All the nine patients were females with mean age of 71 years. The mean duration of bisphosphonate use was 7.2 years. Bisphosphonate treatment was given without significant risk factors before the start of treatment in all the patients. A total of 12 fractures were seen in these patients. Management was successful in all the patients who were treated conservatively. Two patients required revision surgery. Conclusion: Indiscriminate use of bisphosphonates seen in many cases and could be hazardous to the patients. There is need for improved awareness among physicians about the correct use of bisphosphonates including its indication, appropriate duration of use, need for follow up and management of associated complications.

Gigantic idiopathic scrotal calcinosis: A rare case report and review

“…Angiokeratoma and lymphangioma circumscriptum need to be excluded. 15 X-ray of scrotum is usually not advised but if done shows numerous radiopaque shadows corresponding to the calcifications. 16 Biopsy with histologic examination is necessary for definitive diagnosis.…”

“…Under microscopy, the epidermis is intact and amorphous basophilic deposits are noted in the dermis surrounded by a foreign body type of granulomatous inflammation. 16 The calcific deposits stain blue on Grunwald-Giemsa stain, dark blue to black on Von Kossa staining and red colour with Alizarin Red S. 15 Shivkumar et al described fine needle aspiration as a diagnostic modality in calcinosis cutis wherein the aspirate reveals amorphous chalky material that stains positive for calcium. 18 Transmission electron microscopy shows crystal and mineral deposits on degenerated collagen fibrils.…”