Subepidermal calcified nodule
The typical clinical presentation is a solitary, verrucous or smooth papule or nodule on the head or neck in an otherwise healthy child. The majority of lesions are first noted by parents within the first 2 years of life, if not at birth. The largest case series found a 2:1 male predominance. Lesions are almost invariably painless.
The pathogenesis is unknown; however, it may result from underlying adnexal structure damage, previous trauma, or viral infection. SCN is frequently misdiagnosed as far more common entities such as verruca vulgaris, molluscum contagiosum, or epidermal inclusion cyst.
L98.8 – Other specified disorders of the skin and subcutaneous tissue
703086002 – Subepidermal calcified nodule
Differential Diagnosis & Pitfalls
- Verruca vulgaris
- Molluscum contagiosum
- Cutaneous horn
- Epidermal inclusion cyst
- Milia-like idiopathic calcinosis cutis – Considered by some authors to be a variant of SCN. This typically presents in the hands and feet of patients with Down syndrome.
- Calcifying epithelioma of Malherbe is usually a single lesion on the head or neck.
- Dystrophic calcinosis cutis
- Subcutaneous fat necrosis of the newborn
- Iatrogenic calcinosis cutis
- Neonatal heel sticks (see calcified nodules of the heels)
- Intravenous (IV) calcium infusion
- Calcium chloride electrode paste
- Calcium alginate dressings
- Dermal cyst
- Xanthelasma (see xanthelasma palpebrarum)
- Sebaceous cyst
- Juvenile xanthogranuloma