title: Subepidermal Calcified Nodules of the Eyelid Differ in Children and Adults.
abstract: OBJECTIVE
  Subepidermal calcified nodule of the eyelid is considered as one of the types of calcinosis cutis. It generally occurs in children, and is not known to be associated with systemic disease. The authors report histopathological and clinical findings in 14 cases of subepidermal calcified nodule of the eyelid, including 3 older patients with unique microscopic features.
  
  
  METHODS
  Clinical records and pathological materials were critically reviewed in each case, including von kossa, CD3, CD20, and CD68 stains.
  
  
  RESULTS
  The 14 cases presented clinically as nodular eyelid lesions. All were treated with surgical excision. The authors found 2 distinct histopathological patterns which correlated with the patients' age. In young patients, the authors observed multiple, small calcified bodies within the dermis surrounded by chronic inflammation and granulomatous foreign body reaction. On the other hand, in elderly patients, lesions were characterized by a single, large, well-demarcated amorphous calcified deposit surrounded by fibrous tissue, without chronic inflammation or foreign body reaction. One of these patients, a 70-year-old man, also suffered from gout. The presence of subepidermal calcified nodule was not documented as a preoperative diagnostic possibility in any of the cases.
  
  
  CONCLUSIONS
  Subepidermal calcified nodule of the eyelid is a rare condition, but should be considered in any patient presenting with a painless white to yellowish colored nodule of the ocular adnexa, particularly during the teenage years. Clinicians and pathologists should be aware that this entity has a distinct appearance and could be associated with systemic conditions in elderly patients.
authors.affiliation: *Department of Ophthalmology, King Saud University College of Medicine, Riyadh, Saudi Arabia; †Department of Ophthalmic Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.; ‡Katzen Eye Group, Mercy Medical Center, Baltimore, Maryland, U.S.A.; and §King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Saeed
authors.initials: S
authors.lastname: AlWadani
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Suarez
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Kass
authors.forename: Emily
authors.initials: E
authors.lastname: MacQuaid
authors.forename: Deepak P
authors.initials: DP
authors.lastname: Edward
authors.forename: Hind
authors.initials: H
authors.lastname: Alkatan
authors.forename: Charles
authors.initials: C
authors.lastname: Eberhart
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002114:Calcinosis / Q000473:pathology*; D002648:Child; D004817:Epidermis / Q000473:pathology; D005141:Eyelid Diseases / Q000473:pathology*; D005143:Eyelids / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult