- Source: Idiopathic scrotal calcinosis
Idiopathic scrotal calcinosis is a cutaneous condition characterized by calcification of the skin resulting from the deposition of calcium and phosphorus occurring on the scrotum.: 528 However, the levels of calcium and phosphate in the blood are normal. Idiopathic scrotal calcinosis typically affects young males, with an onset between adolescence and early adulthood. The scrotal calcinosis appears, without any symptoms, as yellowish nodules that range in size from 1 mm to several centimeters.
Without known links to other lesions or systemic pre-conditions, scrotal calcinosis was considered idiopathic. It is not related to calcium phosphate imbalance or renal insufficiency. By 2010, studies supported that epidermoid cysts are believed to be caused by dystrophic calcification. This process involves subclinical inflammation, rupture, calcification, and cyst wall obliteration.
Presentation
Single or multiple hard, marble-like nodules of varying size affecting scrotal skin.
Nodules vary in size from a few millimeters to a few centimeters.
Usually start to appear in childhood or early adult life
Over time, nodules increase in number and size
Nodules may break down and discharge chalky material
Rarely, lesions may be polypoid
Usually asymptomatic
Etiology
The cause is not well defined. Originally considered idiopathic condition. Now accepted that majority of cases develop from dystrophic calcification of cyst contents.
Diagnostic
Clinically Relevant Pathologic Features
Lesions slowly progress throughout life
They slowly increase in number and size
Nodules are mobile and do not attach to underlying structures
Pathologic Interpretation Pearls
Globular and granular purple deposits within dermis surrounded by giant cell granulomatous reaction
Sometimes remnants of cystic lesion can be identified
Very distinctive appearance with almost no histologic differential diagnosis.
Treatment
Treatment may involve surgery, which is currently the only recommended intervention. Surgery should include the removal of even small nodules, to prevent the recurrence of the scrotal calcinosis.
Prognosis
Benign condition
Slow progression throughout life
Lesions remain discrete and do not become confluent
Epidemiology
Incidence: uncommon
Age: children and young adults
History
Scrotal calcinosis was first described in 1883 by Lewinski.
See also
Calcinosis cutis
Skin lesion
List of cutaneous conditions
