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Year : 1990  |  Volume : 56  |  Issue : 6  |  Page : 462-463

Subepidermal calcified nodule

Correspondence Address:
S D Shenoi

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How to cite this article:
Shenoi S D, Rao R, Srinivas C R, Balachandran C. Subepidermal calcified nodule. Indian J Dermatol Venereol Leprol 1990;56:462-3

How to cite this URL:
Shenoi S D, Rao R, Srinivas C R, Balachandran C. Subepidermal calcified nodule. Indian J Dermatol Venereol Leprol [serial online] 1990 [cited 2020 May 31];56:462-3. Available from: http://www.ijdvl.com/text.asp?1990/56/6/462/3606

Subepidermal calcified nodule (SCN) is a special form of localized calcification usually found on the face or extremities, histologically consisting of globular calcium deposits in the dermis. We report a case of SCN with an unusual histopathological feature.

A 19 year old male presented `with an asymptomatic skin lesion on the nose of 2 years duration [Figure - 1]. The lesion appeared spontaneously and slowly progressed in size for a year after which it remained static. There was no associated pain or discharge. Examination revealed a chalky white irregular plaque 1.5 cm in diameter with rough surface on the distal part of the nasal bridge. It had a stuck on appearance with a follicular prominence in the centre with surrounding depression. Excision biopsy of the lesion showed hyperkeratosis and a thinned out malpighian layer overlying masses of calcified material in the dermis around dilated hair follicles. Calcification was also seen in the horny layer [Figure - 2].

Subepidermal calcified nodule (SCN) was first described by Winer in 1952 although Duhring used the name cutaneous calculi as early as 1877.[2]

It may be preset at birth or may develop later in life. The lesion is usually solitary although occasionally they may be innumerable. The surface is commonly verrucous but it may be smooth. SCN in young children probably results from calcification of nests of nevus cells or hamartomatous structures.[3]

Histologically calcified material is located in the uppermost dermis although in large lesions, it may extend into the deep dermis. Calcium may be present either as globules or large homogenous masses. Calcium granules when present in the epidermis is indicative of transepidermal elimination.[4] In our case the calcified material in the dermis was present only around dilated hair follicles. We presume 'that the follicular trauma due to the micro comedone has initiated the subepidermal calcification.

  References Top

1.Okun MR and Edelstein LM: Degenerative Dermatoses in: Gross and Microscopic Pathology of Skin, 1st ed, Dermatology Foundation Press, USA, 1976; P 510.  Back to cited text no. 1    
2.Woods B and Kellaway TD: Cutaneous calculi (subepidermal calcified nodules), Brit J Dermatol, 1963; 75 : 1.  Back to cited text no. 2    
3.Pinkus H and Mehregan AK Various Extracellular deposits, in: A guide to Dermatopathology, 3rd ed, Appleton Century - Crofts, USA, 1981; P 308.  Back to cited text no. 3    
4.Lever WF and Schaumburg-Lever G: Metabolic diseases, in: Histopathology of Skin, 6th ed, J.B. Lippincott Company, 1983; p 422.  Back to cited text no. 4    


[Figure - 1], [Figure - 2]


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