Calciphylaxis: An uncommon process of skin necrosis and ulcers. It is associated with calcification of small & medium sized arteries. Risk factors include: women > men; chronic kidney failure w/patients typically on dialysis; elevation in calcium, phosphorous and PTH can contribute; also diabetes, obesity. Common symptoms include: initial finding of painful plaque, nodule, indurated area. This is followed by progressive, severely painful skin ulcers and necrosis. There are usually more than one ulcer and they most commonly affect the thighs, abdomen and buttocks - though other regions can also be involved. The ulcers are slow to heal and associated w/ high mortality (related to the underlying illnesses). Exam is remarkable for: Initial skin findings of painful plaque, nodule, or indurated area. Then often multiple, very painful skin ulcers and necrosis develop, often w/black eschar. These can become infected, in which case inflammatory findings are superimposed. There may also be palpable, calcified sub-cutaneous nodules
Charlie Goldberg, M.D.
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