A young man complains of several tender nodules on the arm and elbow that keep discharging a gritty, white-colored substance.
Key point: The distinct appearance and history are classic for calcinosis cutis—deposition of calcium in the skin. The spicules of calcium erode to the outside, creating the gritty-feeling discharge.
Treatment: The easiest intervention is complete excision, guided by the results of a radiograph. The latter will show the extent of calcium deposition.
Note: There are many reasons for calcinosis cutis, and an appropriate workup is certainly indicated. This would include a search for metabolic derangements (including renal disease), a history of excessive milk ingestion, and signs or symptoms of collagen(Drug information on collagen) vascular disease or sarcoidosis. This patient had dermatomyositis.