LAUSR

milia-like calcinosis cutis. The latter is a rare disorder, characterised by smooth, firm, whitish papules resembling milia. We report the case of an 8-year-old boy with Down’s syndrome who presented with dermoscopically and histologically verified milia-like calcinosis cutis. An 8-year-old boy with Down’s syndrome was referred to our clinic because of numerous skin-coloured papules, 1–3 mm in diameter, mainly on the dorsal aspect of the hands (Fig. 1a). The papules had been present for 2 years. He had no previous trauma or skin eruption at the site of the lesions. Dermoscopy revealed round, white, homogeneous lesions at the centre. Some lesions had a central crust (Fig. 1b,c). Histopathology of a biopsy specimen showed basophilic material surrounded by a thin wall of collagen fibres in the superficial dermis (Fig. 1d). A von Kossa stain confirmed that the material was calcium. We diagnosed the skin lesions as milia-like calcinosis cutis. During follow up, some lesions healed spontaneously. Milia-like calcinosis cutis presents with multiple whitish papules, ranging from 1 to 4 mm in diameter, mainly localised on the upper and lower limbs, and rarely on the face. Whilst most cases have been reported in patients with Down’s syndrome, some have not. Clinically, they may resemble warts, epidermal cysts, molluscum contagiosum and syringoma. Dermoscopy shows white structures in molluscum contagiosum, epidermal cysts and milia-like calcinosis cutis. We found that central crusts in white homogeneous lesions, corresponding to the transepidermal elimination of calcinosis, are unique features. Since most cases revealed transepidermal elimination, we suggest that the dermoscopic feature of the central crust is useful for the diagnosis. Further studies are necessary to confirm the utility of the dermoscopic clue for the diagnosis of milia-like calcinosis cutis.