Multiple Sub-Epidermal Calcified Nodule Mimicking Eruptive Xanthoma: A Case Report and Review of the Literature
A 22-year-old healthy White man presented with asymptomatic, multiple nodules on the bilateral dorsum of hands since he was 10 years old. There was no history of pain, ulceration, or discoloration. Clinical examination was remarkable for 13 lesions (range in diameter 0.2-1 cm), white to yellowish, hard, non-sensitive nodules on the bilateral dorsum of hands []. The case was misdiagnosed as verruca vulgaris and was treated with cryotherapy at different centers. There was no history of preceding lesion or trauma. One of the patient's lesions was excised. Our clinical impression was xanthoma and calcinosis cutis. Histopathology showed homogeneous basophilic masses and granules in the upper dermis, which were surrounded by foreign body reaction and epidermal hyperplasia, an appearance consistent with cutaneous calcinosis [].\nRoutine laboratory tests and metabolic evaluations (calcium, phosphate, and parathyroid hormone), hematological parameters, and blood sedimentation rate were within normal limits. Anti-nuclear antibody was negative. X-ray of the affected hands showed small radio-opaque focuses, but the bony structure did not show any pathology.