Multiple miliare Osteome des Gesichts

Osteoma cutis is a single or multiple ectope calcification with development of bony structures in the skin. We distinguish between primary and secondary ossification. Multiple miliary osteoma in the face has mostly been described secondary to preexisting acne vulgaris. We present a 62-year-old woman who developed multiple miliary osteoma in the face together with repeated doses of estrogen and discuss pathogenesis and therapeutic possibilities.     

Miliary osteoma cutis of the face: treatment with the needle microincision-extirpation method

Multiple miliary osteoma cutis of the face represents primary extra-skeletal bone formation that arises within the skin of the face. Multiple miliary osteoma cutis of the face is a rare complication of chronic inflammatory acne vulgaris and has invasive and non-invasive treatment alternatives different from acne vulgaris. Invasive techniques should be simple, easy, and inexpensive, with minimal risk of scarring and pigmentation. We used a needle microincision-extirpation technique in a patient with multiple miliary osteoma cutis unresponsive to non-invasive treatment modalities. Skin overlying the papules was incised with a needle and then the calcificated papules were extirpated by using a small curettage device. Lesions were left to secondary healing. Results were quite good and cosmetically acceptable.     

Treatment of primary miliary osteoma cutis with incision, curettage, and primary closure

BACKGROUND: Primary miliary osteoma cutis is characterized by de novo bone formation in skin without a known associated or pre-existing cutaneous disorder. These lesions often develop on the face and cause cosmetic concern. OBJECTIVE: Multiple treatments have been attempted, including topical and systemic agents and surgical techniques. The ideal treatment modality should be simple and effective with minimal side effects. METHODS: The technique of scalpel incision over visible lesions, curette extraction of bony fragments, and primary suture repair was used to remove multiple lesions of primary miliary osteoma cutis on the cheeks of an affected patient. RESULTS: This surgical technique resulted in a significant reduction of visible and palpable lesions and a smoother surface contour with minimal scarring. CONCLUSION: This surgical technique offers a simple but effective method for removal of multiple bony fragments in primary miliary osteoma cutis with minimal side effects.     

Multiple cutaneous osteomas of the face associated with chronic inflammatory acne

Multiple miliary osteoma cutis of the face represents a rare and frequently unrecognized complication of chronic inflammatory acne. Their differentiation from microcomedones and macrocomedones may be challenging. The case of a 46-year-old Asian woman who suffered from chronic inflammatory acne is described. She had multiple papular lesions of the cheeks that did not respond to various topical and systemic therapies including oral isotretinoin. Light microscopy studies as well as ultrasound and computed tomography (CT) scan investigations demonstrated the presence of multiple osteoma cutis. Needle microincisions followed by mechanical extirpation of the bony formation resulted in a considerable cosmetic improvement of her skin disease. Knowledge of this rare complication of acne is mandatory, as its treatment is different from that of retentional and inflammatory acne and frequently relies on surgical modalities. Our novel technique consisting of needle microincisions with curettage of the lesions is simple and safe, leading to good cosmetic results.     

Osteoma cutis. Pathogenesis and therapeutic possibilities]

No efficacious therapy for the treatment of increasing and spreading cutaneous ossification is yet established. We report a 52 year old white female with multiple miliary osteomas of the skin involving face, chest and back. The patient has a history of acne vulgaris. A therapeutic trial with a diphosphonate (etidronate disodium) was started in order to stop marked progression and appearance of new lesions. In accordance with the two previously described cases of the literature we failed to achieve any improvement. Clinical features, etiology, classification and therapy of osteoma cutis are discussed.     

Primary multiple miliary osteoma cutis and exogenous ochronosis

Multiple miliary osteoma cutis (MMOC), a rare disorder characterized by the appearance of numerous bony nodules on the face, was initially classified as a consequence of severe, long-standing acne vulgaris. However, several cases have now been described in patients with no preceding history of acne or other inflammatory conditions. We report such a case of primary MMOC in a 75-year-old African American woman and highlight the differences between these conditions. We also note the incidental histologic finding of exogenous ochronosis, which, in our case, indicates the patient's use of hydroquinone-containing bleaching creams in an attempt to treat the disorder.     

Multiple injuries of osteoma skin in the face: therapeutical least invasive in patients with acne sequela - case report

Osteoma cutis is a bone formation in the dermis can to be primary or secondary forms. Only, multiples, many forms, occurring on either sex, they are a rare cutaneous disease. The pathogenesis and classification remains unclear. Our objective was the diagnostic and small invasive surgery treatment of the osteoma cutis multiple of the face, in patients as a sequel of acne. To remove the osteoma we used needle BD 0,70x25 22G1, without anesthetic topic or inject able site. The small wounds were exposed with scarring balsam. We got an excellent esthetic result after 15 days.     

Osteoma cutis as a sequela to facial acne: a case report

Secondary osteoma cutis of the face represents a late, rare, and often unrecognized complication of chronic inflammatory acne. We present the case of a 48-year-old woman with chronic inflammatory acne followed by osteoma cutis formation. The nodules were successfully removed by simple surgical excision.     

Acquired plate-like osteoma cutis

Plate-like osteoma cutis is a rare disorder that has been historically classified as a congenital syndrome. It has a possible relationship to a mutation in the gene (GNAS1) that encodes the α-subunit of the stimulatory G protein, which regulates adenyl cyclase activity. We report a case of extensive plaque-like masses on the scalp and face with no abnormalities in calcium or phosphate metabolism and no preceding inflammatory cutaneous conditions. With less than ten reported cases, to our knowledge, this is one the few cases of acquired plate-like osteoma cutis described in the literature.     

Albright Hereditary Osteodystrophy

Abstract: Albright hereditary osteodystrophy with pseudohypoparathyroidism is due to maternal loss‐of‐function mutations in the GNAS gene. Its typical clinical features encompass obesity, a round face and a short neck, osteoma of the skin, endocrinological abnormalities, and psychomotoric retardation. Here we present a 10‐month‐old Tunisian boy with a classical course of this rare disease.     

Multiple miliäre Osteomata cutis Exstirpation mittels “front-lift”-Zugang

Multiple miliary osteomata of the skin commonly occur on the face and the upper trunk of young healthy women. The mechanism of bone formation is unknown. There is no adequate therapy, which reduces or reverses the growth of osteomatas. Those tumours which are cosmetically disturbing may be excised by a small incision through the skin. For the first time we report their removal via the subcutaneous “front-lift” approach.     

Dapsone in the treatment of miliary lupus of the face

In an uncontrolled study of twelve patients with miliary lupus of the face, dapsone gave good therapeutic results. Miliary lupus of the face (MLF) is an asymptomatic papular eruption affecting the central area of the face, which runs a chronic course and involutes spontaneously with scarring. Histopathologically, the papules usually show scattered masses of tuberculoid granulomata composed of epithelioid cells, giant cells, and an encircling rim of small round mononuclear cells in the dermis. The actiology and pathogenesis of this condition are still unknown. The treatment of MLF has not been satisfactory despite the use of many topical and systemic agents. In this paper we report that dapsone has been found to be beneficial in the treatment of MLF and has accelerated its resolution in twelve patients.     

Miliary osteoma of the face: a report of 4 cases and review of the literature

Osteoma cutis (OC) is a rare disorder characterized by compact bone formation in the dermis and subcutaneous tissue. It is classified in primary and secondary forms according to the presence or absence of previous cutaneous lesions. Miliary osteoma of the face (MOF) is a form of primary OC that generally occurs in middle-aged and older adult women. We report 3 cases of typical MOF and one additional case in a black patient, which to our knowledge has not been described previously.     

Congenital Platelike Osteoma Cutis: Case Report and Review of the Literature

Abstract: An 18-year-old girl had a progressive enlarging plate of subcutaneous bone in the scalp since birth. Histologic examination of the leslon showed typical osteoma cutis. There was no history of any skin disease prior to development of the osteoma. Frequently congenital and usually located on the scalp, platelike osteoma is a rare variant of osteoma cutis.     

Osteoma cutis and hemihypertrophy: a case report.

We report an interesting case of a patient with multiple ipsilateral osteoma cutis lesions and contralateral hemihypertrophy. These two features have not been described together previously. We also review the dermatologic findings described with hemihypertrophy.     

Multiple miliary osteoma cutis is a distinct disease entity: four case reports and review of the literature

Background: Multiple miliary osteoma cutis (MMOC) is a rare nodular skin disease characterized by tiny bone nodules which usually form on the facial skin, typically in middle age. The aetiology of this phenomenon is poorly understood. Objectives: To search for possible bone formation progenitors and to look for a possible association with mutations in the GNAS gene (encoding the G‐protein α‐stimulatory subunit) and related hormonal parameters in patients with MMOC. We also reviewed the literature and discuss the aetiology and pathogenesis of adult‐onset primary osteomas. Methods: We report four cases of MMOC. Histological samples were analysed for bone morphogenetic protein (BMP)‐2, BMP‐4 and oestrogen receptor‐α known to be involved in bone formation. Endocrinological laboratory investigations and hand X‐rays were performed to exclude a systemic disease. The GNAS gene was sequenced from DNA extracted from peripheral blood in all four patients and from a skin sample in one patient to exclude somatic mutations. Results: Histological analyses revealed intramembranous cutaneous bone formation resembling the findings seen in GNAS gene‐based osteoma cutis disorders. However, we did not find any germline or somatic GNAS gene mutations in our patients and all laboratory investigations gave normal results. BMP‐2 and ‐4 were expressed normally in MMOC samples, but oestrogen receptor‐α was not expressed. Altogether 47 MMOC cases, 41 female and six male, have been published between 1928 and 2009. Of these cases, 55% had a history of pre‐existing acne and only 15% had extrafacial osteomas. Conclusions: MMOC is a rare but distinct disease entity of unknown aetiology. Histologically, the tiny nodular osteomas show intramembranous superficial ossification but the aetiology appears to be different from GNAS‐related disorders. The osteomas seem to increase slowly in number after appearing in middle age.     

Panniculitis ossificans traumatica of the lower leg

Heterotopic bone formation in the skin, osteoma cutis, occurs in a variety of clinical settings. Primary osteoma cutis arises in otherwise unaffected skin, often in patients with systemic conditions, whereas secondary osteoma cutis is associated with cutaneous neoplasms and inflammation (metaplastic ossification). Metaplastic ossification almost exclusively affects the dermis. Presented is a patient with posttraumatic bone formation in the subcutaneous fat, panniculitis ossificans traumatica, an entity that has only rarely been reported.     

Epidermolytic hyperkeratosis and congenital platelike osteoma cutis in a child

Epidermolytic hyperkeratosis is a rare congenital ichthyosis. Platelike osteoma cutis also is a rare diagnosis and is associated with abnormal ossification of cutaneous or subcutaneous tissue. A 17-month-old Hispanic girl presented with a plate of subcutaneous bone since birth as well as considerable scaling and hyperkeratosis centered around the joints. Histologic examination confirmed the diagnosis of both epidermolytic hyperkeratosis and osteoma cutis. Although there have been some cases of epidermolytic hyperkeratosis with other dermatologic conditions, we report a rare case of epidermolytic hyperkeratosis and platelike osteoma cutis.     

Osteoma cutis in pseudohypoparathyroidism

Osteoma cutis is the formation of normal bone in the skin. Primary osteoma cutis occurs de novo, whereas the secondary type develops in association with the underlying inflammatory, tumorous or traumatic conditions. Primary osteoma cutis is also associated with Albright's hereditary osteodystrophy (AHO), which can include hypocalcaemic-type pseudohypoparathyroidism (also known as pseudohypoparathyroidism type Ia) or normocalcaemic-type pseudohypoparathyroidism (also known as pseudopseudohypoparathyroidism). We describe a case of osteoma cutis in a 7-year-old boy who had cutaneous, biochemical and phenotypic features of pseudohypoparathyroidism type Ia and AHO.