The So-called Idiopathic Scrotal Calcinosis

To the Editor.—  We read with great interest the article by Swinehart and Golitz entitled "Scrotal Calcinosis: Dystrophic Calcification of Epidermoid Cysts" in the December 1982 Archives (118:985-988). The authors have nicely shown the possible evolution of scrotal epidermoid cysts into scrotal calcinosis and, thus, the so-called idiopathic scrotal calcinosis is not idiopathic. Their findings confirm our earlier article about scrotal calcinosis in which we postulated an inflammatory cause of this unusual condition.¹Although we did not observe any epidermal cysts then,¹ microscopic examination of a biopsy specimen of a new 1-mm lesion on follow-up examination of our patient disclosed a granuloma of a foreign-body type around keratinous material. This finding suggests a ruptured epidermal cyst. This further confirms that so-called idiopathic scrotal calcinosis is not idiopathic and is likely to evolve from epidermal cysts.