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June 2010

Subsequent Development of Syringomas in a Patient With Milialike Idiopathic Calcinosis and Without Down Syndrome

Author Affiliations

Author Affiliations: Divisions of Dermatology, Departments of Internal Medicine (Drs Berk and Bayliss) and Pediatrics (Drs Berk and Bayliss), and Department of Pathology and Immunology (Drs Lu and Lind), Washington University School of Medicine and St Louis Children's Hospital, St Louis, Missouri.

Arch Dermatol. 2010;146(6):680-681. doi:10.1001/archdermatol.2010.119

Our research group previously described a healthy 5-year-old African American girl with widespread milialike idiopathic calcinosis cutis (MICC).1 Since publication of that report, the patient was seen by us for follow-up (at age 13 years) with lesions that had a very different clinical appearance. On physical examination, we found that the previous lesions of calcinosis cutis (presenting clinically as indurated skin-colored and white papules on the chin, neck, trunk, intertriginous areas, and extremities) were rare. Instead, she demonstrated more numerous, widespread, skin-colored, much less indurated papules with near confluence in places (Figure 1). The clinical impression was of syringomas. Multiple shave biopsy specimens demonstrated many comma-shaped and tadpole-shaped cords and nests of epithelial cells and small ducts in the upper dermis, consistent with syringomas (Figure 2). Evidence of calcification was very rare in the new biopsy specimens. The patient did not demonstrate any features of Down syndrome.

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