Subepidermal calcified nodule of the knee with transepidermal elimination of calcium
Subepidermal calcified nodule of the knee with transepidermal elimination of calcium
复制标题
膝关节表皮下钙化结节伴经表皮除钙
DOI：
10.1111/j.1346-8138.2011.01492.x
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发表时间：
2012
期刊：
影响因子：
3.1
通讯作者：
Muto M
中科院分区：
文献类型：
--
作者：
Nakamura Y;Muto M
尊敬的编辑：真皮下钙化结节(SCN)是一种罕见的皮肤钙质沉着症，表现为无症状、孤立的黄白色疣状肿块。这种情况在以男性为主的儿童中最为常见。最常见的部位是头部和颈部。在这里，我们报告了一例SCN病例，患者为一名健康的1岁日本女孩，从出生起就表现为右膝上有一个无痛的结节。切除标本的组织病理学检查显示真皮上部有钙沉积，与SCN的诊断一致。在角质层内观察到钙沉积，提示钙离子经皮肤排出。一名1岁的日本女孩表现为右膝上有一个从出生起就缓慢增大的结节。她是一次简单的怀孕和怀孕39周时正常的自然阴道分娩的产物。体格检查发现，她的右膝有一个边界清楚的黄白色结节，大小为3×2 mm(图1)。结节结节结实，无痛，有一个小坑。初步诊断为毛发粘液瘤，在局麻下采用冲孔切除术切除结节。切除标本的组织病理学检查显示，角化过度和棘皮病的表皮覆盖在乳头状真皮中均一的嗜碱性肿块上(图2a)，与皮肤钙质沉着症的组织学表现一致。Von Kossa染色呈阳性，表明有钙沉积(图2B)。未见局灶性巨细胞异物。角质层内可见钙沉积，提示钙经皮吸收。手术后，我们进行了常规实验室检查，包括评估血清钙、磷、维生素D和甲状旁腺激素水平；这些结果在正常范围内。根据这些发现，我们诊断为SCN。到目前为止，还没有发现复发。
Dear Editor, Subepidermal calcified nodule (SCN) is a rare form of calcinosis cutis that presents as an asymptomatic, solitary, yellow-white verrucous mass. It is found most commonly in children with a male predominance. The most common location is in the head and neck region. Here, we report a case of SCN in an otherwise healthy 1-year-old Japanese girl manifesting as a painless, firm nodule on the right knee that had been present from birth. Histopathological examination of the excised specimen revealed calcium deposition in the upper dermis, consistent with a diagnosis of SCN. Calcium deposition was observed within the stratum corneum suggestive of transepidermal elimination of calcium.A 1-year-old Japanese girl presented with a slowly enlarging nodule on the right knee that had been present from birth. She was the product of an uncomplicated pregnancy and a normal spontaneous vaginal delivery at 39 weeks of gestation. On physical examination, a well-demarcated, yellow-white nodule, 3× 2 mm in size, was present on her right knee (Fig. 1). The nodule was firm and painless with a small pit. An initial diagnosis of pilomatrixoma was made and the nodule was removed by punch excision under local anesthesia. Histopathological examination of the excised specimen showed a hyperkeratotic and acanthotic epidermis overlying a homogeneous, basophilic mass containing granules in the papillary dermis (Fig. 2a), consistent with the histological appearance of calcinosis cutis. Von Kossa staining was positive, indicating calcium deposition (Fig. 2b). A focal giant cell foreign reaction was not seen. Deposition of calcium was observed in the stratum corneum, suggestive of transepidermal elimination of calcium. After surgery, we performed routine laboratory tests including assessment of serum calcium, phosphate, vitamin D and parathyroid hormone levels; these results were within normal limits. From these findings, we diagnosed the lesion as SCN. No recurrence has been noted to date.