Clinical and Dermoscopic Features of Winer's Nodular Solitary Calcinosis

Aims: Solitary nodular calcinosis of Winer is a rare and benign form of localized idiopathic cutaneous calcinosis. Its dermoscopic features may be useful for early diagnosis, but have never been described in the literature to our knowledge.

Case Report: A 5-year-old child presented to our clinic with a 2 years history of a painless keratotic and warty nodule located in the helix of the right ear. A wart was suspected and treated without any improvement. Dermoscopy was performed and showed peripheral white deposits suggestive of Winer's calcinosis, motivating an excision whose histological examination confirmed the diagnosis.

Discussion: The subepidermal calcified nodule has been rarely described in the literature. It is not known to be associated with a disorder of phosphocalcium metabolism or other systemic diseases. Pathogenic hypotheses include calcification of preexisting skin structures, mast cell degranulation with secondary calcinosis, or prior trauma. Surgical excision with histopathological confirmation is necessary to show the dermal calcium deposits, which are usually amorphous and granular and may be surrounded by a lymphohistiocytic infiltrate or giant cells. Nevertheless, dermatoscopic evaluation can aid in rendering a timely diagnosis by showing these whitish dermal deposits.

Conclusion: The diagnosis of Winer's nodular calcinosis has always been based on histology, but the dermoscopy described here for the first time is so suggestive that it can be used to save time and exclude other differential diagnoses.