Idiopathic calcinosis cutis of the scrotum: a case report and review of the literature

Abstract

BackgroundAbnormal deposition of calcium in the skin or subcutaneous tissue is termed calcinosis cutis. Idiopathic calcinosis cutis of the scrotum is an uncommon entity. The pathogenesis of idiopathic calcinosis cutis of the scrotum is debatable. The condition presents as several brown to yellowish nodules on the scrotum, gradually progressive, and mostly asymptomatic. Here we report a case of idiopathic calcinosis cutis of the scrotum with a brief review of the literature and a discussion on pathogenesis.Case presentationA healthy looking, 50-year-old Nepali man presented with multiple growths on his scrotum for 15 years, which were mostly asymptomatic with an occasional complaint of itching. On physical examination, multiple pink to brown nodules ranging in size from 0.5 × 0.5 × 0.5 cm to 3 × 3 × 1 cm, which were painless and firm in consistency, were noted. On laboratory examinations the following were found to be within normal limits: serum calcium, phosphorus, parathyroid hormone, and vitamin D hormone levels; uric acid; alkaline phosphatase; and lipid profile. Based on clinical features and laboratory reports, a diagnosis of idiopathic calcinosis cutis of the scrotum was made. The nodules were excised under local anesthesia in several sittings, which gave a good cosmetic result with no evidence of recurrence in 1-year follow-up period. A histopathological examination revealed dermis with areas of fibrosis and calcification along with numerous multinucleated giant cells and an absence of any cystic structure.ConclusionsIdiopathic calcinosis cutis of the scrotum is a benign condition, which remains mostly asymptomatic. It presents as progressive multiple nodules of varying numbers and sizes. A histopathological evaluation reveals areas of calcification. The cause is either dystrophic calcification of cysts or idiopathic. Excision is the treatment of choice.

Characterizing calcinosis cutis in a pediatric population

“…The idiopathic nature makes this particular subtype a diagnosis of exclusion. The patient is often subjected to numerous diagnostic modalities in an effort to identify an etiology . Idiopathic calcinosis cutis represents the second‐largest cohort of the test group, encompassing a range of sites including the scrotum, lower extremity, nasal folds, hand, and eyelid.…”

An uncommon case of scrotal calcinosis

“…There are a few theories postulated on the pathogenesis. Whether these calcified nodules truly represent an idiopathic disease or whether they arise from epidermal/epidermoid/eccrine cysts as dystrophic calcification is still debated [1,3]. Further, Dartos muscle degeneration causing dystrophic calcification has been hypothesized as an aetiology [1,3,4].…”

“…Whether these calcified nodules truly represent an idiopathic disease or whether they arise from epidermal/epidermoid/eccrine cysts as dystrophic calcification is still debated [1,3]. Further, Dartos muscle degeneration causing dystrophic calcification has been hypothesized as an aetiology [1,3,4]. SC generally do not cause much symptoms and interventions are commonly due to aesthetic disfigurement.…”

“…SC generally do not cause much symptoms and interventions are commonly due to aesthetic disfigurement. Surgical excision and primary closure or complex reconstruction has been the main stay of management [2][3][4]. Many authors suggest complete excision of all minute nodules to prevent recurrence [2][3][4][5].…”

“…Surgical excision and primary closure or complex reconstruction has been the main stay of management [2][3][4]. Many authors suggest complete excision of all minute nodules to prevent recurrence [2][3][4][5]. Laser therapy has been successfully utilized in management of SC recently [5,6].…”