Should scrotal calcinosis still be termed idiopathic?

We observed so-called idiopathic scrotal calcinosis in a 36-year-old man who was cured successfully by simple excision of the affected skin. Histologically, the nodular lesions consisted of calcified amorphous basophilic masses and small granules within the dermis. One rounded aggregate of calcified basophilic material showed a slight positivity on immunostaining for cytokeratin. Some intact epidermoid cysts were also present, suggesting that dystrophic calcification, and possibly inflammation and rupture of epidermoid cysts, may be the main pathogenetic mechanism of the disease in most reported cases. In our opinion, the term idiopathic should refer to the individual cases that are etiologically undefined rather than the whole category of scrotal calcinosis.