eMedicine Specialties > Dermatology > Metabolic Diseases

Osteoma Cutis: Differential Diagnoses & Workup

Author: Kevaghn P Fair, DO, Consultant Pathologist and Founder, Dominion Pathology Laboratories
Contributor Information and Disclosures

Updated: Jan 29, 2009

Differential Diagnoses

Calcinosis Cutis

Other Problems to Be Considered

Cartilaginous tumors of the skin
Foreign body
Gouty tophus
Myositis ossificans
Secondary (heterotopic) ossification

Workup

Laboratory Studies

  • Serum calcium and parathyroid hormone (PTH) levels help to define Albright hereditary osteodystrophy.

Imaging Studies

  • Plain radiographs demonstrate lesions but are not necessary for diagnosis.

Procedures

  • Excisional biopsy for diagnosis, relief of discomfort, or cosmesis may be performed.

Histologic Findings

Small spicules to large masses of mature bone are found in the dermis or extend into the subcutaneous tissue. Spicules of bone may enclose areas of mature fat, recapitulating a medullary cavity, but hematopoietic elements are seldom observed.

A microscopic view of osteoma cutis shows well-fo...

A microscopic view of osteoma cutis shows well-formed mature trabecular bone just beneath the epidermis. Note the absence of hematopoietic elements in the medullary spaces.

A microscopic view of osteoma cutis shows well-fo...

A microscopic view of osteoma cutis shows well-formed mature trabecular bone just beneath the epidermis. Note the absence of hematopoietic elements in the medullary spaces.


More on Osteoma Cutis

Overview: Osteoma Cutis
Differential Diagnoses & Workup: Osteoma Cutis
Treatment & Medication: Osteoma Cutis
Follow-up: Osteoma Cutis
Multimedia: Osteoma Cutis
References

References

  1. Burgdorf W, Nasemann T. Cutaneous osteomas: a clinical and histopathologic review. Arch Dermatol Res. Dec 12 1977;260(2):121-35. [Medline].

  2. Roth SI, Stowell RE, Helwigeb. Cutaneous ossification. Report of 120 cases and review of the literature. Arch Pathol. Jul 1963;76:44-54. [Medline].

  3. Cohen PR, Tschen JA, Schulze KE, Martinelli PT, Nelson BR. Dermal plaques of the face and scalp. Platelike osteoma cutis. Arch Dermatol. Jan 2007;143(1):109-14. [Medline].

  4. Altman JF, Nehal KS, Busam KJ, Halpern AC. Treatment of primary miliary osteoma cutis with incision, curettage, and primary closure. J Am Acad Dermatol. Jan 2001;44(1):96-9. [Medline].

  5. Cohen AD, Chetov T, Cagnano E, Naimer S, Vardy DA. Treatment of multiple miliary osteoma cutis of the face with local application of tretinoin (all-trans-retinoic acid): a case report and review of the literature. J Dermatolog Treat. Sep 2001;12(3):171-3. [Medline].

  6. Baskan EB, Turan H, Tunali S, Toker SC, Adim SB, Bolca N. Miliary osteoma cutis of the face: treatment with the needle microincision-extirpation method. J Dermatolog Treat. 2007;18(4):252-4. [Medline].

  7. Ragsdale BD. Lever's Histopathology of the Skin. Philadelphia, Pa: Lippincott-Raven; 1997:965-7.

  8. Watsky KL. Arndt KA, ed. Cutaneous Medicine and Surgery. Philadelphia, Pa: WB Saunders; 1996:1828-31.

  9. Weedon D, ed. Skin Pathology. 2nd ed. New York, NY: Churchill Livingstone; 2002:355-7.

Further Reading

Keywords

osteoma cutis, bone in the skin, Albright hereditary osteodystrophy, Albright's hereditary osteodystrophy, miliary osteomas

Contributor Information and Disclosures

Author

Kevaghn P Fair, DO, Consultant Pathologist and Founder, Dominion Pathology Laboratories
Kevaghn P Fair, DO is a member of the following medical societies: American Society for Clinical Pathologists, American Society of Dermatopathology, and College of American Pathologists
Disclosure: Nothing to disclose.

Medical Editor

James W Patterson, MD, Director of Dermatopathology, Professor of Pathology and Dermatology, Departments of Pathology and Dermatology, University of Virginia Medical Center
James W Patterson, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Medical Association, American Society of Dermatopathology, Medical Society of Virginia, Royal Society of Medicine, Society for Investigative Dermatology, and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: 3M Pharmaceutical Grant/research funds Other; Graceway Pharmaceuticals Grant/research funds Other

Managing Editor

Rosalie Elenitsas, MD, Herman Beerman Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System
Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology and American Society of Dermatopathology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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