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A 32-year-old African-Caribbean woman presented with multiple painful areas of the
face and neck that were discharging pus and ‘gritty’ material (Fig. 1). Her medical history included lupus and Raynaud’s disease. On examination, we noted
tender, firm, multiple swellings of the bilateral temple and the submental and submandibular
regions, and discharging sinuses. Computed tomography (CT) of the craniofacial region
showed multifocal dermal and subdermal deposits of calcium (Fig. 2). Blood investigations confirmed normal concentrations of serum calcium, phosphate,
and parathyroid hormone. Renal function was normal.
