[Calcific uremic arteriolopathy (calciphylaxis)  : update in 2018]

Area of Science:

• Nephrology
• Dermatology
• Pathology

Background:

• Calciphylaxis is a rare, severe systemic disease.
• It predominantly affects patients with end-stage renal disease.
• The condition has a high mortality rate and poses diagnostic difficulties.

Purpose of the Study:

• To highlight the importance of recognizing cutaneous signs of calciphylaxis.
• To discuss diagnostic challenges and differential diagnoses.
• To outline current treatment strategies and supportive care.

Main Methods:

• Review of clinical presentation and diagnostic criteria for calciphylaxis.
• Discussion of histopathological findings from skin biopsies.
• Analysis of treatment modalities including medical and supportive care.

Main Results:

• Cutaneous signs are key indicators for diagnosis, though skin biopsy, the gold standard, carries risks.
• Differential diagnoses include vasculitis, warfarin-induced skin necrosis, and infectious processes.
• Effective management requires a multidisciplinary approach.

Conclusions:

• Early identification of skin manifestations is critical for initiating prompt and appropriate medical interventions.
• Comprehensive treatment involves pain management, wound care, dialysis, sodium thiosulfate, and metabolic control.
• Palliative care is essential for patients with refractory disease.