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Subepidermal calcified nodule
Other Resources UpToDate PubMed

Subepidermal calcified nodule

Contributors: Andrea C. Medina González MD, Susan Burgin MD
Other Resources UpToDate PubMed


Subepidermal calcified nodule (SCN), also known as Winer's nodular calcinosis or solitary congenital nodular calcification, is a rare form of calcinosis cutis that typically occurs in healthy infants and children. It is considered a form of idiopathic calcinosis cutis, not secondary to previously diseased skin as in dystrophic calcinosis cutis, nor due to metastatic deposits of calcium.

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

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Differential Diagnosis & Pitfalls

  • Common wart
  • Molluscum contagiosum
  • Cutaneous horn
  • Epidermoid 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.
  • Pilomatricoma 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
  • Epidermoid cyst
  • Xanthelasma (see Xanthelasma palpebrarum)
  • Common wart
  • Pilomatricoma
  • Epidermoid cyst
  • Papilloma
  • Juvenile xanthogranuloma
  • Keratoacanthoma
  • Milia

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Last Reviewed:11/11/2020
Last Updated:10/12/2022
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Subepidermal calcified nodule
A medical illustration showing key findings of Subepidermal calcified nodule : Ear, Neck
Clinical image of Subepidermal calcified nodule - imageId=1730361. Click to open in gallery.  caption: 'A white papule at the upper helix.'
A white papule at the upper helix.
Copyright © 2024 VisualDx®. All rights reserved.