Infant heel nodules. Calcification of epidermal cysts

Calcified nodules of the heel have been reported in high-risk neonates following multiple needle sticks to draw blood. Previous reports suggest that the needle stick trauma causes dystrophic calcification. A case of multiple discrete firm heel lesions, which began shortly after birth in an immature-birth weight neonate who had sustained multiple needle sticks of the heel, is presented. Histologically, these lesions demonstrated foci of calcification and fragments of keratin surrounded by an epithelial lining, suggesting that calcified nodules may also arise from epidermal implantation cysts that secondarily calcify.