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[Cutaneous calciphylaxis].
1Klinik für Dermatologie und Allergologie, Krankenhaus Dresden-Friedrichstadt, Städtisches Klinikum, Akademisches Lehrkrankenhaus der Technischen Universität Dresden, Friedrichstr. 41, 01067, Dresden. wollina-uw@khdf.de
Summary
Calciphylaxis is a severe skin condition with high mortality. Early diagnosis and multidisciplinary treatment, including wound care and surgery, improve patient survival and limb preservation.
Area of Science:
- Dermatology
- Nephrology
- Vascular Biology
Context:
- Calciphylaxis is a rare but life-threatening dermatological emergency.
- Characterized by medial calcification, ischemic ulcers, and high mortality (up to 80%).
- Primarily affects patients with end-stage renal disease, but non-uremic causes exist.
Purpose:
- To review the pathophysiology, diagnosis, and treatment of calciphylaxis.
- To highlight the importance of early diagnosis and multidisciplinary management.
- To discuss recent advancements in understanding vascular calcification mechanisms.
Summary:
- Calciphylaxis involves arteriolar calcification, thrombosis, and necrotic skin lesions.
- Predisposing factors include renal disease, hyperparathyroidism, malignancy, and autoimmune disorders.
- Treatment focuses on mineral metabolism normalization, novel medications (bisphosphonates, cinacalcet), and surgical interventions like debridement.
Impact:
- Early recognition by dermatologists is crucial for timely intervention and sepsis prevention.
- Multidisciplinary care involving vascular surgeons and wound specialists improves outcomes.
- Aggressive surgical debridement and skin grafting enhance wound healing and limb salvage.
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