Syed M M Aarif, Rajbhandari Aasiya, Paudel Upama
Department of Dermatology and Venereology, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal.
Department of Pathology, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal.
J Med Case Rep. 2018 Dec 12;12(1):366. doi: 10.1186/s13256-018-1922-6.
Abnormal 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.
A 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.
Idiopathic 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.
皮肤或皮下组织中钙的异常沉积被称为皮肤钙化症。阴囊特发性皮肤钙化症是一种罕见的病症。阴囊特发性皮肤钙化症的发病机制存在争议。该病症表现为阴囊上出现几个棕色至淡黄色的结节，逐渐进展，且大多无症状。在此，我们报告一例阴囊特发性皮肤钙化症病例，并简要回顾文献及讨论发病机制。
一名看似健康的50岁尼泊尔男子阴囊上出现多个肿物15年，大多无症状，偶尔有瘙痒主诉。体格检查发现多个粉红色至棕色结节，大小从0.5×0.5×0.5厘米至3×3×1厘米不等，无痛且质地坚硬。实验室检查发现以下各项均在正常范围内：血清钙、磷、甲状旁腺激素和维生素D激素水平；尿酸；碱性磷酸酶；以及血脂谱。根据临床特征和实验室报告，诊断为阴囊特发性皮肤钙化症。在局部麻醉下分几次切除结节，术后美容效果良好，在1年随访期内无复发迹象。组织病理学检查显示真皮有纤维化和钙化区域，伴有大量多核巨细胞，且无任何囊性结构。
阴囊特发性皮肤钙化症是一种良性病症，大多无症状。它表现为数量和大小各异的进行性多个结节。组织病理学评估显示有钙化区域。病因是囊肿的营养不良性钙化或特发性。手术切除是首选治疗方法。
