Subepidermal Calcified Nodule: Report of Two Cases and Review of the Literature

Abstract

Subepidermal calcified nodule (SCN) is a form of calcinosis cutis that most commonly occurs in children. The typical clinical presentation is of a solitary verrucous nodule on the face, but occasionally multiple lesions may be seen. We describe SCN on the eyelids of two female patients; one of whom had four lesions. The histopathology was typical of calcinosis cutis. Both patients were in good health.

Bilateral Symmetrical Subepidermal Calcified Nodules of the Eyelids

“…The clinical appearance is usually single, solitary, painless, whiteyellowish, raised nodule with papillomatous features. 1,3,5 SCN were not suspected in any of the cases before the pathologic specimen confirmed the diagnosis in the literature. 1,3,5 In differential diagnosis of SCN; pilomatrixoma, warty papilloma, cysts, keratoakanthoma, juvenile xanthogranuloma, cutaneous horn, molluscum contagiosum, xanthelasma, milia and tumour should be thought.…”

“…1,3 It is not associated with metastatic process, previous skin disease or other medical problems. 3 Serum levels of calcium and phosphate are normal. 1 The presence of bilateral and symmetric cases suggests that systemic factors may play role rather than local factors.…”

“…1,3,5 In differential diagnosis of SCN; pilomatrixoma, warty papilloma, cysts, keratoakanthoma, juvenile xanthogranuloma, cutaneous horn, molluscum contagiosum, xanthelasma, milia and tumour should be thought. 1,3 Pilomatrixoma would present as a solitary, painless, irregularly shaped subcutaneous mass beneath red-blue discoloration of the overlying skin frequently in children 6 . Papillomas would present with multiple lesions 1 .…”

“…2 Dystrophic calcification results from an underlying disease, a preexisting dermal nodule or trauma. 3 Iatrogenic calcinosis cutis is due to recent hospitalization with calcium-containing medical devices or medications. 2 Idiopathic calcinosis cutis is not associated with previous trauma or disease in otherwise healthy individuals.…”

“…3 Subepidermal calcified nodule (SCN) is a rare variant of idiopathic calcinosis cutis that usually develops in the first two decades of life as a solitary white or yellow nodule on the face of children. 3,5 We present a rare case of subepidermal calcified nodules of the eyelids which have symmetrical appearance.…”