Author(s) : C. Schepis, M. Siragusa, A. Alberti, Unit of Dermatology, Oasi Institute (IRCCS), via Conte Ruggero, 73, 98418 Troina, Italie.
Summary : An 11 year-old boy affected by Down's syndrome (DS), confirmed by karyotype, was referred to us because he presented with a lot of whitish hard "pustules", ranged in size from 2 to 3 mm in diameter, distributed on his palms and fingers. The parents indicated that some elements, spontaneously eliminated through the skin, had a chalk appearance. The condition had been present for about a year.
Laboratory findings were unremarkable with normal serum levels of calcium and phosphate.
Histological examination of a biopsied lesion revealed hyperortokeratosis in the epidermis and, in the upper dermis, a round calcific nodule surrounded by a thin fibrovascular strip.
What is your diagnosis? Which other perforating condition has been associated with DS?
Pictures
Figure 1. Micronodular, whitish, acral lesion on surface of the palms.
Residual scars are evident.
Figure 2. Histological appearance
of one biopsied lesion. A calcific nodule is recognizable within the upper
dermis (haematoxylin and eosin x 30).
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