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66-Year-Old Female with Painful Lesion on Sole

Can you diagnose this case?

David L. Kaplan 2014 Series Editor @ University of Missouri – Kansas City School of Medicine

Signs and Symptoms

A 66-year-old female presented with a several month history of a painful lesion on her sole that had been treated by multiple specialties, including orthopedics and podiatry, as a corn and as a wart without success.

What is the cause of this lesion?

Choose one to reveal diagnosis and discussion

Plantar wart
Eccrine poroma
Osteoma cutis
Amelanotic melanoma
Intractable plantar keratoses

Answer: Osteoma cutis

See the full case at Consultant360

A biopsy confirmed the diagnosis of a rare and benign condition called osteoma cutis. Strictly defined, osteoma cutis refers to the presence of bone within the skin in the absence of a preexisting or associated lesion. Secondary types of cutaneous ossification can occur in reaction to inflammatory, traumatic, and neoplastic processes — trauma being the most likely cause in this case. Simple excision is curative.

Differential diagnosis: The other options are all reasonable and biopsy is warranted if a presumed diagnosis does not respond to appropriate treatment.

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