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[Calciphylaxis]

T M Proebstle1, T Winter, S Hansen-Schmidt

  • 1Abteilung Dermatologie und Venerologie, Universität Ulm sowie Hautklinik der Charité.

Deutsche Medizinische Wochenschrift (1946)
|August 4, 1995
PubMed
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Dialysis complications can cause severe skin necrosis due to high calcium phosphate product and parathyroid hormone levels. Surgical removal of excess parathyroid glands resolved the patient's painful skin ulcers.

Area of Science:

  • Nephrology
  • Dermatology
  • Endocrinology

Background:

  • Long-term dialysis patients can develop secondary hyperparathyroidism.
  • Elevated serum calcium and phosphate levels are common in chronic kidney disease.
  • Calciphylaxis is a severe complication associated with mineral and bone disorders.

Observation:

  • A 55-year-old woman on dialysis for 6 years presented with acute, zigzag-shaped livid skin markings on her thighs.
  • These lesions rapidly enlarged to 10 cm, developing central dry, painful necroses.
  • Subcutaneous nodules were palpable on extremities, and lab tests revealed hypercalcemia, hyperphosphatemia, and significantly elevated alkaline phosphatase and parathormone levels.

Findings:

  • Histological examination of skin biopsy confirmed calcium phosphate emboli in the main vessels.

Related Experiment Videos

  • Imaging revealed soft tissue and arterial calcifications.
  • The patient had a history of non-adherence to treatment recommendations.

    • Implications:

    • Prompt diagnosis and management of mineral and bone disorders are crucial in dialysis patients.
    • Surgical intervention, such as parathyroidectomy, can be effective in treating severe calciphylaxis.
    • This case highlights the importance of monitoring and managing hyperparathyroidism to prevent severe cutaneous complications.