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Background: The aim this study was to explain the underlying etiology of unknown scrotal masses. Case presentation: This study included 3 patients with a intrascrotal mass. One patient was over 50 years. The remaining patients were between the ages of 30-50. Patients had no serious complaints (two complained about having 3 testicles and one complained of swelling in the scrotum for the last 6 months). All patients underwent scrotal exploration under general anesthesia and the specimen was sent for pathological examination. All masses were mobile and encapsulated. The masses were not associated with the testicle. Two cases had classical histologic features of epidermoid cyst and one had scrotal calcinosis in the pathological report. Physical examination, operation, magnetic resonance and histological images of scrotal masses were shown in the figures. Conclusions: This study is important in terms of showing the underlying etiology of the rare scrotal masses.

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Calcinosis cutis is a rare condition of calcium deposition in skin and subcutaneous tissue. Multiple underlying diseases have been implicated for calcification, the pathogenesis of which is poorly understood. We report a case of calcinosis cutis secondary to chronic myeloid leukemia. The case is being reported for its rarity of association.

Abstract Background 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. Case presentation 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. Conclusions 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.

Calcinosis of soft tissue is a rare but known complication of dermatomyositis (DM), mostly associated with juvenile DM and rare in adult DM. Bone scan with Tc-99m Methylene diphosphonate is useful in disease mapping and has high sensitivity to know the extent of calcinosis. However, there is scanty literature available on the utility of bone scan in treatment response evaluation in DM. Rituximab has been found useful in adult DM with calcinosis unresponsive to conventional treatment. We describe an interesting case showing partial response to rituximab on bone scan with single-photon emission tomography-computed tomography. [ABSTRACT FROM AUTHOR]

Given its excellent safety profile,10 topical STS appears as a promising treatment option for calcinosis cutis. Successful treatment of calcinosis cutis with a topical sodium thiosulphate preparation containing 20% zinc oxide in a patient with sclerotic graft-versus-host disease As observed in our patient, smaller lesions and localized calcinosis cutis can resolve completely after intralesional or topical administration of STS.8 In a recent retrospective evaluation of GvHD patients with calcinosis cutis, four had received treatment with STS but only one improved.4 However, the details of STS treatment were not specified in that report. [Extracted from the article]

Linear calcinosis cutis is a very rare disorder; reported in association with lichen sclerosus etatrophicus, scleroderma, after intravenous infusion of calcium and acute monocytic leukemia. In available literature, idiopathic zosteriform calcinosis cutis is yet to be described. An 8-year-old child presented with spontaneous painful, slowly progressive, linear band-like nodules over the right half of the chest and back of the trunk. Histopathology with special stains was done to confirm the diagnosis. The patient was treated with diltiazem and responded well. We report a case of idiopathic zosteriform calcinosis cutis because of unusual presentation and rarity of the disorder. [ABSTRACT FROM AUTHOR]

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Dear Editor Calcinosis Cutis (CC) is characterized by the deposition of insoluble calcium salts in the skin and subcutaneous tissue. Despite the patient presenting HL as a severe background disease, CC was his main burden, causing a significant impairment to his quality of life. Created with BioRender gl In conclusion, the treatment combination of oral calcium channel blockers, bisphosphonates and topical sodium thiosulfate has shown good effectiveness and safety in the treatment of a case of idiopathic CC in a patient with HL. [Extracted from the article]

The development of calcium salt deposits in the skin can occur in the presence or absence of membranous ossification and are categorized into osteoma cutis (i.e., cutaneous osteoma) and calcinosis cutis. For the former, distinction into primary or secondary osteoma cutis is mainly based on clinical and histopathological parameters, as primary osteoma cutis originates without any underlying intradermal inflammatory or neoplastic process, as opposed to a far greater number of secondary osteoma cutis that occur on the grounds of inflammation or tumors. Genetic disorders might predispose a person to the formation of these overall rare tumors. However, some patients develop primary osteoma cutis in the absence of any genetic background. In pre-menopausal women with fair skin, the condition of multiple miliary osteoma cutis is a relevant differential diagnosis for solid subcutaneous facial nodules. While pathogenesis remains unclear, most affected individuals have suffered from acne vulgaris at some point. Excision might be a viable option for disturbing lesions, as are ablative lasers. Here, we discuss and review relevant causes of calcium salt deposits in the skin based on a notable case of multiple primary osteoma cutis of the face in an otherwise healthy woman. [ABSTRACT FROM AUTHOR]

Calcinosis cutis is the aberrant deposition of insoluble calcified salts in cutaneous tissue that occurs in association with a variety of diseases. A relatively uncommon disorder, it can range in severity from mild to debilitating. This article describes a patient with a long history of dermatomyositis who developed multiple calcific lesions in the extremities that did not respond to conservative therapies and eventually required multiple surgical interventions. [ABSTRACT FROM AUTHOR]

Subcutaneous calcinosis consists of abnormal calcium deposition in soft tissues and is one of the complications of scleroderma, especially in limited systemic sclerosis. It is one of the criteria of CREST syndrome (calcinosis cutis, Raynaud phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia). A 44-year-old woman with systemic scleroderma for 20 years was presented with pain in the elbow, fingers and toes, and extensive calcinosis in soft tissue. The patient was treated with immunosuppressive medications due to lung parenchymal involvement and received various drug and surgical treatments for soft tissue calcinosis. In situations of poor response to medication, surgical treatment could be the only option for treating symptomatic lesions. [ABSTRACT FROM AUTHOR]

Calcinosis cutis is characterized by the deposition of calcium salts in the skin and subcutaneous tissue. It is divided into the following subtypes: dystrophic, metastatic, iatrogenic, idiopathic and calciphylaxis. In this case, we report a 13-year-old Syrian boy with idiopathic calcinosis cutis, the lesions were unusually widespread, unlike the common condition which is usually localized to one area. The case was unrelated to any systemic or local disorders, and the patient had no complications, so no treatment was planned. As the best of our knowledge, there are very few cases of diffuse or widespread idiopathic calcinosis cutis. We analyzed the clinical, laboratory, radiographical and pathological characteristics of our patient, which helped us to reach the final diagnosis. We will discuss the pathogenesis, investigation and management of this disease. [ABSTRACT FROM AUTHOR]

Background: Calcinosis cutis is a rare condition associated with different diseases, which is difficult to manage. Aims and Objectives: In this retrospective study, the epidemiology of calcinosis cutis and the effectiveness of various treatment regimens in its management were assessed in a single center. Materials and Methods: The data of 34 patients suffering from calcinosis cutis (male:female = 12:22; mean age = 48.6 ± 18.6 years) treated at our department between 2003 and 2016 were analyzed retrospectively. Results: Dystrophic, idiopathic, metastatic subtype, and calciphylaxis occurred in 70.6%, 11.8%, 5.9%, and 11.8% of the cases, respectively. Underlying diseases of dystrophic calcinosis included autoimmune connective tissue disease, skin trauma, cutaneous neoplasm, and inherited disorder in 58.3%, 20.8%, 12.5%, and 8.3% of the cases, respectively. Extremities were most frequently affected (n = 18). In the management, diltiazem was most frequently used in monotherapy with partial response in five of eight cases. Other drugs in monotherapy or in combination were administered in single cases. Surgical treatment resulted in least partial response in all of the cases followed (n = 7). Conclusion: Dystrophic was the most common subtype and autoimmune connective tissue disease was the most frequent underlying disease. We conclude that lower doses of diltiazem have only partial efficiency, and surgical therapy is at least partially effective in localized calcinosis. [ABSTRACT FROM AUTHOR]

Background: We have limited data on the treatment of calcinosis cutis associated with systemic sclerosis and dermatomyositis.Objective: To assess the efficacy and tolerance of available treatments for calcinosis cutis based on previously published studies.Methods: We performed a systematic review of studies published in Medline, Embase, and the Cochrane library during 1980-July 2018. The strength of clinical data was graded according to the modified Oxford Centre for Evidence-Based Medicine levels of evidence.Results: In all, 30 studies (288 patients) were included. Eleven therapeutic classes, surgery, and physical treatments were identified as potential treatment options for calcinosis cutis. On the basis of results of a small randomized controlled trial and 4 retrospective studies, low-dose warfarin should not be used for calcinosis cutis (level IB evidence). The results of several studies suggest diltiazem and bisphosphonates might be useful treatment options (level IV). Considering biologic therapies, rituximab has shown promising results in treating both dermatomyositis and systemic sclerosis, whereas tumor necrosis factor inhibitors might be useful for treating juvenile dermatomyositis (level IV). Intralesional sodium thiosulfate might be a promising alternative (level IV).Limitations: Few included studies had a high level of evidence.Conclusion: This study highlights the efficacy and tolerance profiles of available treatments for calcinosis cutis, with a focus on level of evidence. [ABSTRACT FROM AUTHOR]

(1) Background: Calcinosis cutis is a frequent symptom of autoimmune connective tissue diseases leading to pain, transcutaneous expulsion of calcified material and bacterial superinfection. There is a high need for new therapeutic options as no standardized treatment algorithm is established. While case reports indicate beneficial effects of bisphosphonates, standardized evaluation of treatment effects is missing. (2) Methods: In this retrospective analysis we evaluate the effects of intravenous pamidronate, a second-generation bisphosphonate, in seven patients with calcinosis cutis using consecutive clinical pictures, radiological examinations and patient’s subjective evaluation. (3) Results: 5/6 patients reported a reduction of pain, improvement of general condition and cessation of calcinosis progression. Regression of skin lesions was detectable in clinical pictures of 2/6 patients, while 1/6 patients had stable disease. Radiological examination revealed improvement or stable disease in 3/5 patients. Fever was the most common side effect. One out of seven patients developed osteonecrosis of the jaw. (4) Conclusions: Bisphosphonates appear to have beneficial effects in a subgroup of calcinosis cutis patients. While patient’s subjective evaluation was mainly positive, objective assessments showed improvement in approximately half of the cases. With regard to potential severe side effects, a careful risk-benefit evaluation is necessary before treatment initiation.

Systemic sclerosis (SSc) is an autoimmune disease with fibrosis of the skin and/or internal organs, causing a decrease in quality of life and survival. There is no causative therapy, and the pathophysiology of the SSc remains unclear. Studies showed that lipid metabolism was relevant for autoimmune diseases, but little is known about the role of lipids in SSc. In the present study, we sought to explore the phospholipid profile of SSc by using the lipidomics approach. We also aimed to analyze lipidomics results for different clinical manifestations of SSc. Experiments were performed using high-performance liquid chromatography coupled to mass spectrometry for the lipidomic profiling of plasma samples from patients with SSc. Our study showed, for the first time, significant changes in the level of phospholipids such as plasmalogens and sphingomyelins from the plasma of SSc patients as compared to controls. Phosphatidylcholine plasmalogens species and sphingomyelins were significantly increased in SSc patients as compared to controls. Our results also demonstrated a significant association of changes in the metabolism of phospholipids (phosphatidylcholine and phosphatidylethanolamine plasmalogens species and sphingomyelins) with different clinical manifestations of SSc. Further lipidomic studies might lead to the detection of lipids as new biomarkers or therapeutic targets of SSc.

CPD questions Learning objective To demonstrate up to date knowledge regarding the aetiology, presentation and treatment of dystrophic calcinosis cutis. This case illustrates a presentation with dystrophic calcinosis cutis recalcitrant to several treatment modalities. [Extracted from the article]

Background : Skin conditions are among the most common health problems in India. Skin biopsy is the most common diagnostic technique for diagnosing skin disease. The interpretation of the skin biopsy require clinicopathological correlation. Materials & Methods: The present study was undertaken in the department of Pathology, Kakatiya Medical College & MGM Hospital Warangal, Telangana to determine the incidence & age – sex distribution of various skin diseases, to study the various histopathological changes encountered in the course of study & to establish clinicopathological correlation. A total number of 249 biopsies retrieved from the archives during the period of January 2013 to June 2015 along with clinico - pathological correlation. On the basis of histopathological classification the skin disorders are divided into eight groups. Results: Maximum number of cases belonged to group VI disorders i.e disorders showing tumors & cyst of dermis & subcutis 85 ( 34.1%), followed by group V disorders i.e disorders showing perivascular, diffuse & granulomatous infiltrates of the dermis 44 (17.6%). Out of 249 skin biopsies which came for histopathological evaluation, 197 (79.1%) cases were given definite diagnosis by microscopic examination of slides. Amongst 197 cases, clinico-pathological correlations was seen in 134 (54%)cases. Highest number of cases are seen in 21 - 30 yrs of age, with majority of cases were male than female Conclusion: Our study showed most of cystic lesions of dermis,followed by benign tumors ( capillary hemangioma) and carcinomas, calcinosis cutis emphasizing that enivironment had some role to play.

Calcinosis cutis is a rare disorder characterized by the deposition of calcium in the skin and subcutaneous tissue. Unilateral idiopathic calcinosis cutis has only rarely been reported in the literature. Here, we report the case of a 7-year-old healthy girl who presented with multiple asymptomatic hard nodules on the right side of her body. Histopathological, radiological, and extensive blood investigations confirmed the diagnosis of unilateral idiopathic calcinosis cutis.

However, these calcifications are rarely associated with morphea and even more infrequently with radiation therapy.1 We report a case of radiation-induced morphea in combination with dystrophic calcinosis cutis of the breast. None of the cases describing calcinosis cutis in conjunction with morphea described radiation as an inducing factor.5 Although radiation-induced morphea and radiation-induced calcinosis cutis have been reported independently from each other, to the best of our knowledge, we report the first case of radiation-induced morphea with dystrophic calcinosis cutis. Although the exact mechanism has yet to be determined, the current proposed mechanism involves an inciting event leading to excessive collagen production and deposition.2 Calcinosis cutis is defined as the deposition of insoluble calcium in the skin and subcutaneous tissue. [Extracted from the article]

Calcinosis cutis is a rare presentation and not many cases have been reported especially of idiopathic type. We are reporting a case of idiopathic calcinosis cutis of lower limbs in a 33-year old female who presented to our clinic for multiple painless swellings over her lower limbs for the past six months, without any history of trauma or infection. We have decided to observe her condition on regular follow-up and conservative management.

Calcinosis cutis is a rare metabolic disorder characterized by cutaneous and subcutaneous deposition of insoluble calcium salts. Ocular adnexal involvement is uncommon but mostly seen in males and in the upper eyelid. Solitary lesions are more common than multiple. The treatment of choice is excision biopsy. Histopathological examination provides a definitive diagnosis. Directed systemic investigations help to rule out underlying pathologies and aids further management. The present case reports the punctal and peripunctal involvement in a case of ocular adnexal calcinosis cutis.

(H&E, 4X) gl Discussion Calcinosis can occur for a variety of reasons, and we propose that the calcinosis cutis associated with our patient's linear type morphea is an example of idiopathic calcinosis cutis. Morphea, or localized sclerosis, is an autoimmune disorder that is characterized by inflammation and sclerosis of the skin. Rare presentation of calcification associated with long-standing linear morphea. [Extracted from the article]

The article discusses a survey which aimed to gauge the thoughts and opinions of calcinosis patients regarding the clinical burden of the disease and of the treatment of their calcinosis. Topics covered include questions included in the survey, the impact of calcinosis on the daily life of patients, and the widespread distribution of calcinosis in terms of body sites affected confirmed by the survey results.

We report a case of a patient with a history of remote orthotopic heart transplant (OHT) started on rapamycin secondary to cardiac allograft vasculopathy (CAV) who subsequently developed calcinosis cutis. A 43 year old male underwent OHT in 2003. His immediate post-operative course was complicated by an arterial embolism requiring a right lower extremity (RLE) lateral fasciotomy. In 2017, he was noted to have a prolonged conduction delay on a Holter monitor. He underwent coronary angiography and significant CAV was diagnosed. Rapamycin was initiated, in addition to mycophenolate mofetil and tacrolimus, which he remained on until August 2021 when he presented with a non-healing wound of his RLE fasciotomy site, fever, and leukocytosis. Blood cultures were positive for Group B streptococcus requiring IV antibiotics. He underwent debridement and biopsy of the wound, which showed calcium deposits in the dermis with evidence of ossification, consistent with a diagnosis of calcinosis cutis. Rapamycin was discontinued. A thorough rheumatologic and dermatologic workup was negative. Calcium, phosphorous, parathyroid hormone, and vitamin D levels were normal. Patient initially underwent multiple debridement; but there was concern this exacerbated the calcinosis cutis and impeded healing. Over the course of the next three months, as shown in Figure 1, there was significant improvement of the RLE wound with the discontinuation of rapamycin. We describe a rare case of a cardiac transplant recipient who developed CAV that was treated with rapamycin and developed dystrophic calcinosis cutis. Dystrophic calcinosis is most commonly associated with connective tissue disease as well as devitalized tissue from trauma or infection, such as with our patient's fasciotomy scar. This is a rare cutaneous manifestation in the setting of immunosuppression with rapamycin, highlighting the complex balancing act of impaired wound healing and infection with management of CAV in our transplant patients. [ABSTRACT FROM AUTHOR]

Conclusion Fully ablative continuous-wave CO SB 2 sb laser therapy may be an effective method for treating calcinosis cutis. Calcinosis cutis can be divided into 4 major subtypes: dystrophic, metastatic, idiopathic, and iatrogenic.[1] The most common type is dystrophic, which is typically associated with a systemic inflammatory disease such as systemic sclerosis, dermatomyositis, mixed connective tissue disease or lupus, where tissue damage acts as a nidus for calcification.[2] Reported treatment options include sodium thiosulfate, intralesional corticosteroids, diltiazem, warfarin, bisphosphonates, minocycline, ceftriaxone, aluminum chloride, probenecid, colchicine, intravenous immunoglobulin, extracorporal shockwave lithotripsy, diode laser, Erbium YAG, picolaser, carbon dioxide (CO SB 2 sb ) laser, and surgical management.[[1], [3]] Of these therapies, continuous-wave CO SB 2 sb laser therapy has displayed consistent resolution of calcified nodules and improvement in pain, but is rarely used. Over 8 months, she successfully underwent 4 treatments of continuous-wave CO SB 2 sb laser therapy with curettage for 5 nodules on 4 fingers without complications. [Extracted from the article]

The most common type of CC is dystrophic calcinosis, which occurs in previously damaged or neoplastic tissues or in association with underlying connective tissue disease in the presence of normal phosphorous and calcium concentrations. (e) Epidermal hyperkeratosis with stratified squamous epithelium, and small, multiple, dark basophilic-stained granular calcium deposits in densely fibrotic dermis; a picture consisted with "calcinosis cutis" (Hematoxylin & Eosin stain, x 100) gl Calcinosis cutis (CC) is abnormal progressive deposition of calcium in the skin and subcutis associated with both normal and elevated serum calcium levels. There are three types of idiopathic CC, i.e. familial tumoral calcinosis, subepidermal calcified nodules, and scrotal calcinosis. [Extracted from the article]

Idiopathic scrotal calcinosis is a rare benign condition which presents with asymptomatic multiple nodules on the scrotal skin. We report a 45-year-old Indonesian male, presented with multiple nodules on scrotum with variable sizes. Histopathological examination reveals extensive intradermal deposition of calcium surrounded by histiocytes and without cystic structure. Surgical excision of the nodules from the scrotal skin was done without any complications. And there has been no recurrence for the past six months at follow-up. [ABSTRACT FROM AUTHOR]

This literature review summarizes current data on the epidemiology, pathophysiology, diagnosis and treatment of calcinosis cutis in patients with systemic sclerosis (SSc). The article deals with the analysis of observational studies of the frequency of calcinosis in SSc and associated clinical features, molecular research of potential pathogenetic mechanisms, clinical cases describing new diagnostic approaches and methods for the treatment of calcinosis. Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. Calcinosis is one of the main, poorly managed clinical problems in patients with SSc, affecting at least one quarter of patients with SSc. Calcinosis is associated with a longer disease duration, digital ulcers, acro-osteolysis, positive anticentromere and anti-topoisomerase antibodies. Although the pathogenesis of calcification is not fully known, there is evidence supporting the role of local chronic traumatization, chronic inflammation, vascular hypoxia and malregulation of bone matrix proteins as potential mechanisms for the development of this pathological condition in patients with SSc. The diagnosis can be established on the basis of clinical data or using plain X-ray. Several pharmacological treatment methods have been applied in patients with calcinosis with variable and not so significant results; in turn, surgical excision of calcium deposits remains mainstay of treatment. [ABSTRACT FROM AUTHOR]

Acquired perforating calcific collagenosis (APCC), which is characterized by the calcification of dermal collagen fibers with subsequent transepidermal elimination and perforation, is an extremely rare entity. Thus far, it has only been reported in a patient with direct contact exposure to calcium chloride. Here, we report a unique case of APCC occurring in a drug addict admitted for rhabdomyolysis. The present case is a 20‐year‐old male patient hospitalized for drug‐related rhabdomyolysis and multiple organ damage. During hospitalization, he gradually developed unusual skin rashes. There were multiple confluent umbilicated and keratotic erythematous to brownish papules and plaques with scratch‐like linear plaques on his lower abdomen, inguinal areas and gluteal sulci. Also, multiple well‐demarcated flesh‐colored rough, hard and thin plaques with a "crepe paper"‐like texture were found on the bilateral popliteal fossae, olecranon fossae and axillae. The histopathology of two biopsied lesions demonstrated acquired perforating calcific collagenosis. The lesions appeared during the rhabdomyolysis‐related hypercalcemia phase and resolved spontaneously after the calcium level returned to normal. This is the first reported case of disseminated APCC occurring during transient hypercalcemia due to rhabdomyolysis. [ABSTRACT FROM AUTHOR]