Clinical-epidemiological, Cytological and Histopathological Study of Idiopathic Calcinosis Cutis of the Scrotum

Abstract

Introduction: Idiopathic Scrotal Calcinosis (ISC) is characterized by a solitary or multiple, painless intradermal nodules in the presence of normal levels of calcium and phosphate and in the absence of any systemic metabolic disorder. Aim: To study the clinical, cytological and histopathological aspect of Idiopathic Scrotal Cutis in this geographical region and find a possible correlation between ISC and an increase in calcium compounds in the soil and water due to cement pollution in this region with many cement factories. Materials and Methods: In this study, we report twenty cases of this rare entity diagnosed over a ten year period from 2007 to 2016. A detailed history of all the patients which included age, occupation, serum calcium and phosphorus levels, FNAC and USG reports and histopathological slides was reviewed to confirm the diagnosis and study the possible pathogenesis of ISC. Results: The patient’s age ranged from 19 to 65 years with a mean of 37.2±11.4 years. The duration of swelling varied from two to 24 months, mean of 8.8±5.2 months. The most common occupation in the present study was farmers (7/20). The predominant presentation was that of scrotal swellings (17/20) and most common clinical diagnosis was sebaceous cysts (11/20). A history of white chalky discharge from the swelling was present in four cases. No metabolic disorders were noted in any patients. Solitary nodules were noted in fourteen cases which ranged from 0.5 to 3.5 cm. Histopathological examination of the nodules revealed dermal masses which were calcified and few cases were associated with a prominent foreign body reaction. All twenty cases underwent surgical excision and showed no recurrence in follow up. Conclusion: Increased levels of calcium in water could have a favourable role in the occurrence of this otherwise rare entity, inspite of normal calcium levels in the body.

Keywords

• Calcium
• Dermal nodules
• Dystrophic calcification
• Phosphorous