Osteoma cutis D23.0

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

Dieser Artikel auf Deutsch


cutaneous ossification; Cutaneous ossification; Genuine osteomas of the skin; Heterotopic bone formation; Heterotopic Ossification; Osteoma; Osteomas of the skin real; subcutaneous ossification

This section has been translated automatically.

Rare, benign, congenital or later manifesting, mostly multiple skin tumors, which are caused by dermal ossification.

This section has been translated automatically.

A distinction is made between:

  • primary (neoplastic)
  • secondary (metaplastic) osteomas.

The classification of osteomas is not uniform. Some authors use the term "osteoma cutis" only for primary ossifications that do not occur in the context of osteodystrophia hereditaria. S.a. Osteosis cutis multiplex.

This section has been translated automatically.

In primary osteomas the cause is unclear. Discussed are a transformation of omnipotent connective tissue cells into osteoblasts, a dislocation of bone germ centres, the perception of the osteoma as a hamartoma and an inherited predisposition.

In secondary osteomas (heterotopic ossification), chronic inflammatory processes, especially in acne vulgaris, trauma, chronic venous insufficiency, endocrinological disorders (pseudohyperparathyroidism) form the basis for heterotopic ossification. Here, metaplasia is discussed, whereby mesenchymal cells in a suitable inflammatory milieu) differentiate into osteoblasts.

This section has been translated automatically.

Mainly occurring on the capillitium (osteomas of the scalp) or face (osteosis multiplex faciei).

Clinical features
This section has been translated automatically.

Pinhead size, rough nodules and/or extensive hard, bumpy infiltrates. Childhood osteomas are also a concomitant symptom of pseudohypoparathyroidism.

This section has been translated automatically.

All forms of cutaneous ossification require the detection of mature, lamellar bone tissue at the cutis-subcutaneous border. There are irregularly shaped bone bundles, in the marginal areas osteoblasts and osteoclasts in Howship's lacunae. Osteoid is detectable. Secondary ossification can be distinguished from primary ossification by the fact that a connection to a pre-existent process can still be established (e.g. to an inflammatory or neoplastic process).

This section has been translated automatically.

Histology. X-rays: Smoothly defined, bone-tight shadows.

Differential diagnosis
This section has been translated automatically.

This section has been translated automatically.

Cosmetically or functionally disturbing foci can be addressed surgically. Small osteomas are treated by incision or pricking, larger foci are excised. Trials with dermabrasio and tretinoin are partly successful. Subsequent increased occurrence of osteomas is described in some cases!

Therapeutic approaches with diphosphonates such as etidronic acid (e.g. Diphos) have been tried in some patients without significant effect.

This section has been translated automatically.


This section has been translated automatically.

  1. Chabra IS et al (2014) Evaluation and management of multiple miliary osteoma cutis: case series of 11 patients and literature review. Dermatol Surgery 40: 66-68.
  2. Julian CG et al (2003) Osteoma cutis in a lesion of solitary morphoea profunda. Clin Exp Dermatol 28: 673-674
  3. Martin J et al (2012) Infantile osteoma cutis as a presentation of a GNAS mutation. Pediatric Dermatol 29: 483-484
  4. Nakamura S et al (1987) Primary Osteoma Cutis. J Dermatol 14: 85-88
  5. Paisini C et al (2015) Multiple miliary cutaneous osteomas of the capillitium. JDDG 143: 1185-1187
  6. Roth SI et al (1963) Cutaneous Ossification. Arch Catholic 76: 56-66
  7. Schrallhammer K et al (1988) Primary osteoma cutis. dermatologist 39: 509-513
  8. Senti G et al (2001) Multiple miliary osteomata cutis. Excision with "front lift" approach. Dermatologist 52: 522-525
  9. Stockel S et al (2002) Multiple miliary osteomas of the face. dermatologist 53: 37-41
  10. Vashi N et al (2011) Acquired plate-like osteoma cutis. Dermatol Online J 17:1 Review.


Please ask your physician for a reliable diagnosis. This website is only meant as a reference.


Last updated on: 29.10.2020