RESUMO
Iatrogenic calcinosis cutis represents a subset of calcinosis cutis resulting secondary to treatments or procedures. We present the first report of calcinosis cutis resulting from the intraosseous infusion and one of a few cases with associated transepidermal elimination. A previously healthy 2-year-old female presented with a new-onset unilateral shin rash 1 week following hospitalization for a near-drowning event. A dermatologic exam revealed multiple small, tender, firm, chalky-white papules with surrounding erythema, in addition to two erythematous macules superior and medial to the papular lesions, corresponding to prior intraosseous access sites. The rash persisted despite trials of topical mupirocin and acyclovir cream, prompting a referral to a dermatologist. An excisional biopsy was performed, revealing circumscribed dermal deposits of acellular basophilic material connected to the overlying epidermis through an invaginated keratin plug. A von Kossa silver stain highlighted the deposits, confirming the diagnosis of perforating calcinosis cutis. The lesions did not recur following the excisional biopsy. Iatrogenic calcinosis cutis may be seen as a complication of the infusion of calcium-containing fluids via intraosseous access, in addition to the more commonly observed peripheral intravenous access. Awareness of this disorder is important in order to distinguish it from an infectious mimic and guide the selection of therapy.
Assuntos
Calcinose Cutânea , Calcinose , Exantema , Afogamento Iminente , Dermatopatias , Feminino , Humanos , Pré-Escolar , Calcinose/etiologia , Calcinose/tratamento farmacológico , Calcinose/patologia , Infusões Intraósseas/efeitos adversos , Afogamento Iminente/complicações , Doença Iatrogênica , Dermatopatias/etiologiaRESUMO
Military grooming standards assure that soldiers are able to meet their occupational demands and maintain a respectable appearance; however, following these standards can unmask or exacerbate various skin diseases of the head and neck. In this article, we emphasize some of the more common disorders caused by military grooming standards, including a discussion of the underlying pathogenesis and management considerations.
