Title : A contradictory case of facial multiple miliary osteoma cutis
Abstract:
Osteoma cutis is a rare dermatologic condition where bone tissue develops within the skin. This condition is divided into two forms: primary, which is rare and develops de novo in healthy skin, and secondary, the more common variant that results from trauma, inflammation, or neoplastic processes. Of the multiple subtypes that develop from these forms, miliary osteoma cutis is the most common subtype, typically arising around the face. A 69-year-old female with no significant medical history presented to the dermatology clinic complaining of several firm, white-colored papules on her forehead that had increased in quantity over the past year. While the patient was unaware of any recent trauma to the area, she claimed the lesions developed shortly after receiving her first Candela VBeam Perfect treatment for cosmetic purposes. She had several more cosmetic treatments with Candela Smoothbeam 1450nm and Iridex 532nm to eliminate the lesions, but they were all unsuccessful. A biopsy of the affected area confirmed the patient had developed osteoma cutis. This case of multiple miliary osteoma cutis is particularly rare, as it developed without any known predisposing risk factors. Our patient did not exhibit common associations such as trauma to the area, disorders of calcium homeostasis, cystic acne, or skin cancer. While laser therapy is typically used as a treatment modality for osteoma cutis, it has served as a potential trigger in this case. We hypothesize that cutaneous trauma, including laser treatments, may induce osteoma cutis in predisposed individuals, highlighting the need for further investigation into this paradoxical mechanism.
