The patient had a scar in this area from previous excision of a basal cell carcinoma. No other significant cutaneous findings were detectable. Analysis of the x-ray film demonstrated multiple tiny calcifications in the patient's skin on the upper part of his trunk. A 6-mm punch biopsy specimen revealed several areas of mature bone in the upper dermis. Comment Multiple miliary osteomas of the skin are rare.
Osteoma cutis is characterized by the formation of bone in dermal or subcutaneous sites.
Although unassociated with Albright hereditary osteodystrophy, histological features of osteoma cutis reveal a typical lamellar bone architecture. Multiple idiopathic osteomas are most commonly reported in the faces of women who have a history of acne. However, the exact relation of osteoma cutis to acne remains unclear because some patients without acne have been described. We describe a patient with multiple primary miliary osteoma cutis in whom there was no evidence of acne or other abnormalities. Only 10 cases of multiple primary miliary osteoma cutis in adults have been documented.