Idiopathic scrotal calcinosis
Hardening of the scrotum skin
From Wikipedia, the free encyclopedia
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.[2]: 528 However, the levels of calcium and phosphate in the blood are normal.[3] Idiopathic scrotal calcinosis typically affects young males, with an onset between adolescence and early adulthood.[3] The scrotal calcinosis appears, without any symptoms, as yellowish nodules that range in size from 1 mm to several centimeters.[4]
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.[5] 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.[6]
Presentation
The presentation is as follows:[citation needed]
- 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.[4][7] Originally considered idiopathic condition. Now accepted that majority of cases develop from dystrophic calcification of cyst contents.[citation needed]
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
Prognosis
The prognosis is as follows:[citation needed]
- Benign condition
- Slow progression throughout life
- Lesions remain discrete and do not become confluent
Epidemiology
- Incidence: uncommon[citation needed]
- Age: children and young adults[citation needed]
History
Scrotal calcinosis was first described in 1883 by Lewinski.[4]