Idiopathic calcinosis cutis of the vulva

Vulvar calcinosis cutis in a female dog with urinary incontinence secondary to an ectopic ureter

A 2-year-old, spayed female standard schnauzer dog was presented with a history of urinary incontinence and painful whitish lesions localized to the vulvar region. An ectopic ureter was diagnosed by cystoscopy. Histopathology of the biopsy specimens from the vulvar lesions was compatible with calcinosis cutis. Seven weeks following the cystoscopic laser ablation of the ectopic ureter and resolution of the urinary incontinence, the calcinosis cutis lesions completely resolved without any specific treatment. To the authors' knowledge, vulvar calcinosis cutis secondary to urinary incontinence has not been previously reported in a dog. Key clinical message: This is the first case report in the veterinary literature of vulvar calcinosis cutis in a female dog due to urinary incontinence.

Idiopathic tumoral calcinosis presenting in early childhood

Idiopathic calcinosis (IC) is deposition of calcium hydroxyapatite crystals or amorphous calcium with no predisposing cause. IC presents in juxta-articular tissue in a tumour-like fashion is known as idiopathic tumoral calcinosis (ITC). Recurrent trauma and chronic pressure are thought to be the triggering factors. It usually presents in adolescents and adults. Presentation in early childhood is a rarity. We are reporting ITC in an 8-year-old child with the onset at 4 years of age.

Calcinosis Cutis of the Vulva: A Review

Idiopathic calcinosis cutis (CC) is an uncommon skin condition. Although it has been reported many times in the scrotum, it is exceedingly rare in the vulva. Most reports of vulvar CC are in children. Vulvar CC may be thought clinically to be inclusion cysts. Other causes of calcinosis such as autoimmune disease or alterations in serum calcium levels, potentially associated with malignancy, must be considered before considering a case as idiopathic.

Idiopathic calcinosis cutis of the scrotum: a case report and review of the literature

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 cutis: A rare cause for difficult airway

Calcinosis cutis is a rare clinical condition wherein calcium is deposited in the layers of the skin. Various types of calcinosis cutis have been described based on histology and location. Airway may be involved only if calcinosis cutis is associated with overlapping syndrome of connective tissue disorders and muscular dystrophy. I report a rare case of dystrophic calcinosis cutis without any connective tissue disorders with the unanticipated difficult airway. A young lady with dystrophic calcinosis cutis of the gluteal region was posted for surgical excision and flap cover procedure under general anesthesia. Unanticipated difficult airway situation arised and was effectively managed. Patient had an uneventful recovery.