Cutaneous Deposits

Abstract

: The cutaneous deposition disorders are a group of unrelated conditions characterized by the accumulation of either endogenous or exogenous substances within the skin. These cutaneous deposits are substances that are not normal constituents of the skin and are laid down usually in the dermis, but also in the subcutis, in a variety of different circumstances. There are 5 broad categories of cutaneous deposits. The first group includes calcium salts, bone, and cartilage. The second category includes the hyaline deposits that may be seen in the dermis in several metabolic disorders, such as amyloidosis, gout, porphyria, and lipoid proteinosis. The third category includes various pigments, heavy metals, and complex drug pigments. The fourth category, cutaneous implants, includes substances that are inserted into the skin for cosmetic purposes. The fifth category includes miscellaneous substances, such as oxalate crystals and fiberglass. In this article, the authors review the clinicopathologic characteristics of cutaneous deposition diseases, classify the different types of cutaneous deposits, and identify all the histopathologic features that may assist in diagnosing the origin of a cutaneous deposit.

Pigmented colloid milium associated with exogenous ochronosis in a farmer with long-term exposure to fertilizers

“…Colloid milium is a rare cutaneous deposition disorder (deposition of amorphous material in the dermis) 1 which is characterized by translucent papules developing on light sun-exposed regions including the face, neck and dorsal aspects of the hands and back. 1,2 The four variants are (1) an adult-onset type, (2) a juvenile form, (3) a nodular form (nodular colloid degeneration), and (4) a pigmented form.…”

“…The cause remains unknown. 1 Exogenous ochronosis (EO) is an uncommon disorder characterized by the deposition of microscopic, ochre-colored pigment in the dermis, giving rise to a blue-black hue in the skin. It is usually manifested by asymptomatic blue-black macules on photo exposed areas, predominantly on bony prominences (malar areas, temples, lower cheeks, and neck), and it is often associated with the prolonged application of various topical chemical substances, such as hydroquinone, phenol, resorcinol, mercurial, and picric acid, as well as with quinine injections and oral antimalarial agents.…”

“…1,2 The four variants are (1) an adult-onset type, (2) a juvenile form, (3) a nodular form (nodular colloid degeneration), and (4) a pigmented form. 3,4 The etiology of colloid milium is uncertain.…”

Skin manifestations of endocrine diseases

“…The calcification of subcutaneous adipose tissue accompanied by fat necrosis is usually identified. In severe cases, calcification of subcutaneous peripheral nerves and sweat glands can be seen (13).…”

Hyperkeratotic cutaneous vascular malformation associated with familial cerebral cavernous malformations (FCCM) with KRIT1/CCM1 mutation

“…In addition, other risk factors such as renal failure, peritoneal dialysis and pruritus were also associated [8]. On the contrary, secondary PD includes calcinosis cutis or calcified trichilemmal cysts and is associated with oxalate crystal deposition that usually contains calcium salts and calcifications [9,10]. The term "acquired PD" covers three clearly distinct entities, "acquired reactive perforating collagenosis", "elastosis perforans serpiginosa" and "per- forating folliculitis" [5].…”