Osteoma cutis - Neoplasia or Paleogenetics?

Abstract

Osteoma cutis, also called multiple miliary osteoma cutis is a rarely described dermatosis, and in cases that are not associated with Albright’s hereditary osteodystrophy, osteoma cutis is being defined as a skin type of hamartoma, with mesenchymal cell differentiation in bone tissue. Levels of biochemical parameters (such as serum calcium, alkaline phosphatase and parathormones) are usually within the reference range when dermal osteomas are found. When osteoma cutis formations are X-ray detected (as it often happens when a computer tomography for dental purposes is performed) they manifest as small nodules in the skin with bone density ranging from 1 to 3mm. The very few presence in literature of osteoma cutis cases is due to the fact that the condition is usually asymptomatic and/or its scarce expression is misdiagnosed as milia, fatty hyperplasia or fatty cysts. Reported in this paper are 14 (fourteen) cases of osteoma cutis. It is discussed their occurrence is due to chronic inflammatory processes (acne), and/or pathogenic behavior of skin injuring (patomimia) that unlock suppressed genes (paleo genes) to protect the skin, that are similar to the bone tiles (osteoderms) present in many vertebrates.