pISSN: 1011-8942 eISSN: 2092-9382 Calcinosis Cutis at the Tarsus of the Upper Eyelid Ikhyun Jun1, Sung Eun Kim 1 , Sang Yeul Lee1, Gi Jeong Kim2, Jin Sook Yoon1 1Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea 2Department of Pathology, Yonsei University College of Medicine, Seoul, Korea Calcinosis cutis involves the inappropriate deposition of calcium within the dermis layer of the skin, and is often as- sociated with rheumatoid disease. A 42-year-old woman presented for evaluation of a hard palpable mass on the left upper eyelid. After everting the eyelid, a large papillomatous mass with a broad base was identified on the superi- or area of the tarsus. The lesion was partially excised posteriorly under local anesthesia, and pathologists identified the mass as calcinosis cutis. The patient had no systemic or trauma history, and the serum levels of calcium and phosphorous were normal. Idiopathic calcinosis cutis should be included in the differential diagnosis for a protruding papillomatous mass of the tarsal plate, and surgical debulking could be a viable option for large protruding lesions, although more follow-up is necessary to monitor regrowth. Key Words: Calcinosis cutis, Idiopathic, Papillomatous mass, Tarsus Korean J Ophthalmol 2011;25(6):440-442 http://dx.doi.org/10.3341/kjo.2011.25.6.440 Case Report Calcinosis cutis is a recognizable disorder characterized by the deposition of amorphous calcium and phosphate salts under the epidermal layer [1,2]. This condition is frequently associated with rheumatoid disease, and can lead to pain and disability in these patients [3]. Calcinosis cutis can be div- ided into four types: dystrophic, metastatic, iatrogenic, and idiopathic. The dystrophic type is observed in damaged or devitalized tissues, while the metastatic type is associated with high serum levels of calcium or phosphate, as can be seen with various systemic diseases. The iatrogenic type of calcinosis cutis is generally associated with calcium-containing medical devices or medications [2], and the idiopathic type occurs in the absence of tissue injury or detectable disease in otherwise healthy individuals. Several cases of idiopathic calcinosis cutis involving the scrotum, penis, vulva, breast, or extremities have been de- scribed [1,3,4]. A subepidermal calcified nodule, which is a form of calcinosis cutis, on the eyelid beneath the skin has al- so been reported [5]. There is a case of ossification of the eyelid and orbit in a patient with pseudo-pseudohypopar- athyroidism [6]. However, there has been no report of idio- pathic calcinosis cutis protruding from the tarsus. This is the Received: October 26, 2010 Accepted: December 16, 2010 Corresponding Author: Jin Sook Yoon, MD. Department of Ophthalmology, Yonsei University College of Medicine, #250 Seongsan-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: 82-2-2228-3570, Fax: 82-2-3463-1049, E-mail: yoonjs@yuhs.ac first case report of idiopathic calcinosis cutis occurring at the upper tarsus in a healthy woman. Case Report A 42-year-old woman presented for evaluation of a slow- growing, painless, palpable mass on the left upper eyelid, which initially developed several years earlier. She was a hepatitis B virus carrier, but otherwise in a healthy condition. No history of orbital trauma or filler injection was reported. At the time of her first visit, her uncorrected vision was 1.0 for both eyes. Under slit-lamp examination, slight conjunctival Fig. 1. Papillomatous mass involving the tarsus is shown in the left eye. ⓒ 2011 The Korean Ophthalmological Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses /by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 440