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Skinmed 2022A 39-year-old woman presented with a 4-year history of asymptomatic facial lesions that has progressively increased in number to become a cosmetic nuisance. These... (Review)
Review
A 39-year-old woman presented with a 4-year history of asymptomatic facial lesions that has progressively increased in number to become a cosmetic nuisance. These lesions have not responded to 6-months of topical 20% azelaic acid, 0.1% retinoic acid, and 20% vitamin C combination. She has had mild papulopustular acne. Her personal and family histories were unremarkable. On dermatologic examination, there were multiple flesh-colored to pigmented, firm ovoid to round papules, 2-5 mm in size, over the forehead and both cheeks (Figure 1). The dermatoscopic examination was nonspecific. Preliminary diagnoses were made of eccrine syringoma, steatocystoma multiplex, and papular elastorrhexis. A histopathologic examination from a punch biopsy displayed focal ossification within the dermis (Figure 2). Routine laboratory tests, including serum calcium, phosphorus, PTH, and vitamin D levels were within the normal ranges. A maxillofacial 3D CT scan, revealed multiple dermal and hypodermal ossifications, <3-5 mm in size-in the frontal, mandibular, and maxillary areas of the face (Figure 3). Scattered osteomas were also seen on the neck. A definitive diagnosis of multiple miliary osteoma cutis (MMOC) of the face and neck was firmly established based on clinical, histologic, and radiologic findings. Radiologically, the distribution and extent of the lesions were more pronounced than clinically anticipated. (. 2022;20:469-471).
Topics: Female; Humans; Adult; Military Personnel; Bone Diseases, Metabolic; Skin Diseases, Genetic; Sweat Gland Neoplasms
PubMed: 36537686
DOI: No ID Found -
The American Journal of Dermatopathology Jan 2023Perforating osteoma cutis is a benign proliferation of mature bone within the dermis and subcutaneous tissue of the skin with transepidermal elimination. Transepidermal...
Perforating osteoma cutis is a benign proliferation of mature bone within the dermis and subcutaneous tissue of the skin with transepidermal elimination. Transepidermal elimination of bone is the hallmark of perforating osteoma cutis and is defined by the breaching of bone through the epidermis. Perforating osteoma cutis is exceptionally rare because only 6 cases have been recorded in the literature at the time of preparation of this report. In this report, we present the case of a 65-year-old female patient with a medical history of nonmelanoma skin cancer, hypertension, hyperlipidemia, and type II diabetes mellitus presented for evaluation of a skin lesion of the posterior lower left leg, which had been present for 1 year. Clinical and histopathologic findings were consistent with the diagnosis of acquired perforating osteoma cutis. Treatment with surgical removal by tangential biopsy has thus far proven to be both diagnostic and therapeutic because no recurrence has been noted as of 6 months.
Topics: Female; Humans; Aged; Osteoma; Diabetes Mellitus, Type 2; Skin Diseases, Genetic; Ossification, Heterotopic
PubMed: 36484608
DOI: 10.1097/DAD.0000000000002318 -
Cureus Sep 2022The most common tender cutaneous neoplasm is a dermatofibroma. The characteristics of three women (35 to 42 years old) with painful dermatofibromas are described. One...
The most common tender cutaneous neoplasm is a dermatofibroma. The characteristics of three women (35 to 42 years old) with painful dermatofibromas are described. One woman was receiving immunosuppressive therapy for the past decade following a liver transplant; the other women were healthy. The dermatofibroma was located on the buttock, shoulder, and arm, respectively; tumor-related pain had been present for several months to at least a year. The dermal nodules ranged in diameter from 5 millimeters to 12 millimeters and were either flesh-colored to slightly red or brown or tan; one tumor was surrounded by a hyperpigmented patch. Microscopic examination showed the following dermatofibroma variants: classic (fibrocollagenous) in two women and histiocytic in one woman. All the women experienced resolution, without recurrence, of pain following the punch biopsy that only removed the majority (but not all) of the dermatofibroma. Tender cutaneous neoplasms include not only dermatofibromas and other fibrous lesions, but also adipose, bone, calcium, cartilage, eccrine, infiltrative, lymphoproliferative, muscle, neural, and vascular tumors. Acronyms and acrostics are mnemonic devices that have been used by clinicians to aid in recalling the diagnoses associated with painful skin tumors. When there were only 11 or less number of pain-related cutaneous conditions, shorter acronyms associated with either a woman's name, a country or an egg were used. A unique acrostic inspired by Charlotte's Web, a children's book by E. B. White, was created when the differential diagnosis of tender cutaneous neoplasms expanded to 25 tumors. The sequential discovery of additional tender skin lesions resulted in two subsequent minor revisions to the original, hog-related, mnemonic. Herein, a new acrostic -- that is not only able to incorporate the inspiration from Charlotte's Web, but also includes cutaneous lymphoma and a final category of "everything else" in order to maintain the future integrity of mnemonic -- for the painful tumors of the skin is proposed: HOG FLED PEN AND GETS CALM LIFE BACK (hidradenoma, osteoma cutis, glomus tumor, fibromyxoma [superficial acral], leiomyosarcoma [cutaneous], eccrine angiomatous hamartoma, Dercum's disease, piezogenic pedal papule, eccrine spiradenoma, neurilemmoma, angiolipoma, neuroma, dermatofibroma, granular cell tumor, endometriosis [cutaneous], thrombus [cutaneous organizing], scar, calcinosis cutis, angioendotheliomatosis [reactive], leiomyoma, metastases [cutaneous], lymphoma [cutaneous], intravenous lobular capillary hemangioma, foreign body [and foreign body reaction], everything else, blue rubber bled nevus, angioma [tufted], chondrodermatitis nodularis helicis, and keloid).
PubMed: 36321023
DOI: 10.7759/cureus.29713 -
Clinical Case Reports Oct 2022The patient had a history of acne vulgaris at a young age. The excisional biopsy from the nodule of the face showed the findings of multiple miliary osteoma cutis...
The patient had a history of acne vulgaris at a young age. The excisional biopsy from the nodule of the face showed the findings of multiple miliary osteoma cutis (MMOC). As were identified in calcified nodules, may be one of the triggering factors for MMOC. MMOC patients need proper skin care because the subcutaneous calcification is slowly formed even after middle age.
PubMed: 36285033
DOI: 10.1002/ccr3.6492 -
International Journal of Dermatology Dec 2022
Topics: Humans; Cheek; Skin Diseases, Genetic; Ossification, Heterotopic; Bone Diseases, Metabolic; Skin Neoplasms
PubMed: 36256466
DOI: 10.1111/ijd.16453 -
Cureus Aug 2022Here, we report a case of a 70-year-old female who presented with a slowly enlarging tender nodule on the right forearm for several months. Physical examination showed a...
Here, we report a case of a 70-year-old female who presented with a slowly enlarging tender nodule on the right forearm for several months. Physical examination showed a faintly blue-tinged freely mobile subcutaneous nodule. Excision was complicated by greater than expected bleeding and revealed an unexpected intravenous mass. Histopathology demonstrated capillary lobules separated by fibrous septae within a vein, consistent with intravenous lobular capillary hemangioma (IVLCH). IVLCH is a rare benign capillary proliferation of unclear etiology. Excision is typically curative and relieves any pain and discomfort the patient might be experiencing. With the addition of IVLCH, we respectfully propose a new acronym for the differential diagnosis of cutaneous tender tumors: intravenous lobular capillary hemangioma, foreign body (reaction), hidradenoma, osteoma cutis, glomus tumor, scar, fibromyxoma, leiomyosarcoma, eccrine angiomatous hamartoma, Dercum's disease (adiposis dolorosa), piezogenic pedal papule, eccrine spiradenoma, neurilemmoma (schwannoma), calcinosis cutis, angioendotheliomatosis, leiomyoma, metastases, angiolipoma, neuroma, dermatofibroma, granular cell tumor, endometriosis, thrombus, blue rubber bleb nevus, angioma, chondrodermatitis nodularis helicis, and keloid ("IF HOGS FLED PEN, CALM AND GET BACK"). Future additions to the cutaneous tender tumor differential diagnosis may require creative additions and rearrangements to this acronym. However, continual updates will allow it to serve both clinicians and pathologists alike as a comprehensive representation of etiologies to consider for cutaneous tender tumors.
PubMed: 36120217
DOI: 10.7759/cureus.28030 -
Journal Francais D'ophtalmologie Nov 2022
Topics: Humans; Lacrimal Apparatus; Ossification, Heterotopic; Skin Diseases, Genetic; Bone Diseases, Metabolic
PubMed: 35691741
DOI: 10.1016/j.jfo.2022.01.024 -
Children (Basel, Switzerland) May 2022Pseudohypoparathyroidism (PHP) is a rare, heterogeneous disorder characterized by end-organ resistance to parathyroid hormone (PTH). PTH resistance causes elevated PTH...
Pseudohypoparathyroidism (PHP) is a rare, heterogeneous disorder characterized by end-organ resistance to parathyroid hormone (PTH). PTH resistance causes elevated PTH levels, hypocalcemia, and hyperphosphatemia. Since hypocalcemia causes life-threatening events, early diagnosis is crucial. However, the diagnosis of PHP is elusive during infancy because PHP is usually diagnosed with hypocalcemia-induced symptoms, which develop later in childhood when calcium requirements increase. A 1-month-old girl was referred to our clinic for elevated thyroid-stimulating hormone (TSH) levels on newborn screening. When measured 1 month after levothyroxine treatment, her TSH level normalized. At 4-months-old, multiple hard nodules were noted on her trunk. A punch skin biopsy revealed osteoma cutis associated with Albright's hereditary osteodystrophy, a major characteristic of PHP. We performed targeted sanger sequencing of the gene and detected a heterozygous variant c.150dupA (p.Ser51Ilefs*3) in both the proband and her mother, causing frameshift and premature termination mutations. The patient was diagnosed with PHP Ia when she had normal calcium, phosphorous, and PTH levels. We report the early diagnosis of PHP Ia without hypocalcemia. It emphasizes the importance of meticulous physical examination in patients with congenital hypothyroidism.
PubMed: 35626900
DOI: 10.3390/children9050723 -
Gerodontology Jun 2022Miliary osteoma cutis (MOC) is a cutaneous disorder that develops in response to an ill-defined process or following acne vulgaris. Most cases present incidentally as...
INTRODUCTION
Miliary osteoma cutis (MOC) is a cutaneous disorder that develops in response to an ill-defined process or following acne vulgaris. Most cases present incidentally as small radiographic aggregations of normal bone within the cheeks. Infrequently, MOC has been reported with systemic disease, including renal failure.
CASE PRESENTATION
An 82-year-old man presented with renal failure and secondary hyperparathyroidism. Intraoral radiographs displayed bilateral radiopacities. This is the first documented case of MOC synchronous with renal failure and secondary hyperparathyroidism in a geriatric patient.
CONCLUSIONS
Patients with MOC and manifestations associated with nephropathy should undergo a comprehensive medical work-up and laboratory studies. Timely recognition of incidental radiographic findings may improve clinical outcomes.
Topics: Aged; Aged, 80 and over; Bone Diseases, Metabolic; Female; Humans; Hyperparathyroidism, Secondary; Male; Ossification, Heterotopic; Renal Insufficiency; Skin Diseases, Genetic; Skin Neoplasms
PubMed: 35526226
DOI: 10.1111/ger.12576 -
Journal of Nippon Medical School =... Nov 2022Cutaneous ossification is a rare benign dermatological condition in which bone forms in the dermis or subcutaneous tissue. It is classified as primary when it emerges...
Cutaneous ossification is a rare benign dermatological condition in which bone forms in the dermis or subcutaneous tissue. It is classified as primary when it emerges without a pre-existing condition and secondary when it is associated with an underlying condition such as trauma, scars, inflammation, or neoplastic disease. The secondary form accounts for most cases of cutaneous ossification. The pathogenesis of cutaneous ossification is not clear. Keloids are benign fibroproliferative skin disorders characterized by chronic inflammation. Their pathogenesis is also not fully understood. We report two cases of postoperative secondary ossification in lower abdominal keloids and review the literature on secondary ossification of the skin. We speculate that severe chronic inflammation in keloids drives osteoblastic transformation of mesenchymal stem cells, endothelial cells, or fibroblasts in the keloids.
Topics: Humans; Keloid; Endothelial Cells; Inflammation; Abdomen
PubMed: 35400721
DOI: 10.1272/jnms.JNMS.2022_89-502