Clinical and histological features of a case of the so-called idiopathic calcinosis of the scrotum in a 22 year-old otherwise healthy man are presented. In a first biopsy we did not observe any evidence of squamous epithelial lining around calcified masses, but in a second one we observed some intact epidermoid cysts and granulomas of foreign-body type around keratinous material. These findings suggest that scrotal calcinosis is not idiopathic, but rather the end stage of dystrophic calcification of scrotal epidermoid cysts.