International Journal of Trichology

: 2019  |  Volume : 11  |  Issue : 2  |  Page : 93--95

Dermoscopy of secondary osteoma cutis over the scalp

Feroze Kaliyadan1, Duddi Sreehari Krishna Swaroop2, Farhan Asif Siddiqui3,  
1 Department of Dermatology, King Faisal University, Hofuf, Al-Ahsa, Saudi Arabia
2 Department of Biomedical Sciences, Division of Pathology, King Faisal University, Hofuf, Al-Ahsa, Saudi Arabia
3 Department of Laboratory and Blood Bank, King Fahd Hospital, Hofuf, Al-Ahsa, Saudi Arabia

Correspondence Address:
Dr. Feroze Kaliyadan
Department of Dermatology, King Faisal University, Hofuf, Al-Ahsa
Saudi Arabia

How to cite this article:
Kaliyadan F, Krishna Swaroop DS, Siddiqui FA. Dermoscopy of secondary osteoma cutis over the scalp.Int J Trichol 2019;11:93-95

How to cite this URL:
Kaliyadan F, Krishna Swaroop DS, Siddiqui FA. Dermoscopy of secondary osteoma cutis over the scalp. Int J Trichol [serial online] 2019 [cited 2021 Apr 17 ];11:93-95
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Full Text


A 19-year-old male patient presented to the dermatology outpatient clinic with a history of a swelling over his scalp of 7 years' duration. The lesion was asymptomatic except for mild tenderness. He had a history of pus-filled lesions at multiple sites on the scalp, including the current one, which later developed into hard lesions. He was intermittently treated with shampoos and antibiotics. The patient and his family had no history of any other significant skin or systemic disease.

On examination, a hard, nontender nodule was seen on the scalp, measuring approximately 2 cm × 2 cm in size with an adjacent smaller nodule of similar consistency [Figure 1]. Dermoscopy (Foto II Pro, ×10, polarized) showed central areas of whitish-yellow structure-less areas with peripheral whorled and cerebriform patterns [Figure 2]. The structure-less areas correspond to the areas of ossification. All the other laboratory investigations, including calcium and Vitamin D levels, were within the normal limits. A final diagnosis of osteoma cutis, probably secondary to a folliculitis, was made.{Figure 1}{Figure 2}

Excision biopsy from the lesion showed focal areas resembling eosinophilic bony tissue and showing osteoblastic rimming along with scattered osteocytes within distinct lacunae [Figure 3] and [Figure 4].{Figure 3}{Figure 4}

Osteoma cutis refers to the formation of normal bone tissue within the skin. Osteoma cutis can be primary, when it develops de novo, without any preexisting skin lesion or secondary, after any inflammation, injury, or tumor.[1],[2],[3] Ossification can occur in two ways mainly – either because of mesenchymal cells differentiating into osteoblasts or by osteoblastic metaplasia of mesenchymal cells like fibroblasts. Primary osteoma cutis can occur in different forms – multiple miliary osteoma, isolated osteoma, and congenital plaque-like osteoma cutis. Primary osteoma cutis can also be associated with syndromes such as Albright's hereditary osteodystrophy.[1] To the best of our knowledge, dermoscopy of osteoma cutis has not been well described in the available literature. The dermoscopic differential diagnosis would include other causes of dystrophic calcification, which can also show whitish structure-less areas. However, osteoma cutis can be easily differentiated on histopathological examination, which shows well-circumscribed nodule of mature lamellar bone with osteoblastic rimming, within the dermis.[4]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.


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