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.