What Is It Wednesday

This is a 76 year old lady from Mexico whose chest was horribly burned more than 70 years ago as a child in a fire. She never developed breasts because of the destruction of tissue on her chest wall. Her family brought her to me because of this tissue that looked like bone that was sticking out of her chest. That same week I saw a 36 year old woman also from Mexico with a 30 year old chest wall burn and she had an identical lesion. What is this stuff? What procedure do you need to perform on all old burn scars?

calcinosis2

Yes, it is heterotopic calcification or calcinosis cutis which is relatively common in old burn scars like this. If you can remove the calcium sometimes the ulcer will heal. The problem is that the calcium forms again. It can be darn near impossible to get these lesions to resolve. The procedure you need to perform is a biopsy because the chronic inflammation over many years can lead to the development of squamous cell carcinoma (SCCA). I biopsied both ladies the same week and the reports came back the same day. One was positive for SCCA.

Guess which patient had squamous cell skin cancer? The 36 year old woman.