Calcinosis cutis-calcification in soft tissue-is a rare benign disease that is separated into the following subtypes: dystrophic, iatrogenic, metastatic, calciphylaxis, and idiopathic. One of common site of calcinosis cutis is the scrotum. The nodules slowly grow for years or decades. The characteristic of calcinosis cutis of the scrotum is generally asymptomatic, yellowish marble-like, hard, polypoidal, solitary, or multiple. However, the pathogenesis of this nodule remains ambiguous and controversial. Thus, we reviewed possible causes and therapeutic consideration of calcinosis cutis of the scrotum.
Calcinosis* ; Calciphylaxis ; Scrotum* ; Skin

Calcemic uremic arteriolopathy or calciphylaxis is an uncommon disorder presenting clinically as skin ischemia and necrosis, and histologically as vascular calcification and thrombosis of dermal and subdermal vasculature. This study described two Filipino females with end-stage renal disease on chronic dialysis with non-healing ulcers on the lower extremities as a result of calcification in the vessels of the dermis and subcutaneous fat with associated fat necrosis. Current understanding of its various histologic features was reviewed for proper diagnosis.

Calciphylaxis ; Vascular Calcification ; Kidney Failure, Chronic ; Calciphylaxis ; Ulcer

Metastatic calcification is rare; it is found during autopsy in patients who underwent hemodialysis. Diffuse calcium precipitation of small and medium-sized cutaneous vessels, known as calciphylaxis, can result in progressive tissue necrosis secondary to vascular calcification. This condition most commonly involves the skin; however, a rare occurrence of visceral calciphylaxis has been reported. Here we report on an autopsy case. Despite a thorough evaluation, and even performing an autopsy, the underlying cause of acute-onset hypercalcemia, resulting in the production of pulmonary calciphylaxis and metastatic renal calcification associated with acute respiratory and renal failure, could not be determined. Metastatic calcification often lacks specific symptoms, and the degree of calcification is a marker of the severity and chronicity of the disease. This unusual autopsy case emphasizes the importance of rapidly progressing visceral calciphylaxis, as well as its early detection.
Autopsy ; Calciphylaxis ; Calcium ; Humans ; Hypercalcemia ; Necrosis ; Renal Dialysis ; Renal Insufficiency ; Vascular Calcification

Calciphylaxis is a rare condition primarily occurring in patients with end-stage renal disease and involving mural calcification of small vessels. It has a high mortality rate, with death in the majority of cases occurring from sepsis. Most cases are characterized by rapid progression of tender subcutaneous nodules or cutaneous plaques to epidermal necrosis. The condition is still poorly understood. This is a report of two cases, both females, 50 and 51 years of age, with chronic kidney disease undergoing hemodialysis and peritoneal dialysis respectively, three times a week. They presented with tender patches and plaques with subsequent development of eschars and ulceration. Biopsies confirmed the presence of calcification within vessel walls in the subcutis. They were both managed conservatively with proper wound care and surgical debridement but eventually expired after a few months.

Human ; Biopsy ; Calcinosis ; Calciphylaxis ; Debridement ; Kidney Failure, Chronic ; Peritoneal Dialysis ; Renal Dialysis ; Renal Insufficiency, Chronic ; Sepsis

Calcific uremic arteriopathy (CUA), termed calciphylaxis, is a rare but highly fatal clinical syndrome. There is no clearly laboratory diagnostic criteria for CUA. The medium and small arterial calcification and microthrombosis discovered by skin biopsy, radiologic imaging，bone scan and the evidence of activation of the bone morphogenetic protein signal (BMPs) transduction pathway are useful for early diagnosis of this disease. The common therapies (including intravenous sodium thiosulfate (STS) and bisphosphonates, hyperbaric oxygen therapy and other symptomatic supports) are used for the management of wounds, pain, nutrition, dialysis and so on. Controlling the chronic kidney disease-mineral and bone disorder (CKD-MBD) and some complications of dialysis and drugs (such as warfarin, active vitamin D) can prevent CUA. However, CUA patients still have poor prognosis and high mortality. Since some patients progress rapidly, it is of great importance to make early diagnosis and provide effective treatments with multidisciplinary management.
Calciphylaxis ; diagnosis ; prevention & control ; therapy ; Early Diagnosis ; Humans ; Renal Dialysis ; Uremia ; Warfarin

Calciphylaxis is a rare, but serious disorder that is usually observed in patients with renal disease and secondary hyperparathyroidism. It is characterized by the ischemic necrosis of the skin, the underlying tissue and other organs, as well as rapid vascular calcification. Prompt diagnosis and management is required because the intractable skin necrosis sometimes causes lethal sepsis. Sevelamer hydrochloride is an ion-exchanging resin that binds phosphates in the gut without increasing the calcium load. Treatment with it may lead to less vascular calcification and better survival for patients with chronic renal disease. Herein we present a case of calciphylaxis with renal failure and the patient improved after treatment with sevelamer hydrochloride therapy.
Calciphylaxis ; Calcium ; Humans ; Hyperparathyroidism, Secondary ; Necrosis ; Phosphates ; Polyamines ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Sepsis ; Skin ; Vascular Calcification ; Sevelamer

Tumoral calcinosis (TC) is a condition resulting from extensive calcium phosphate precipitation, primarily in the periarticular tissues around major joints. Calciphylaxis is a fatal ischemic vasculopathy mainly affecting dermal blood vessels and subcutaneous fat. This syndrome is rare and predominantly occurs in patients with end-stage renal disease. Here, we report on a rare case involving a patient with TC complicated with calciphylaxis. Our patient was a 31-year-old man undergoing hemodialysis who presented with masses on both shoulders and necrotic cutaneous ulcers, which were associated with secondary hyperparathyroidism, on his lower legs. He underwent subtotal parathyroidectomy, and sodium thiosulfate (STS) was administered for 27 weeks. Twenty months after beginning the STS treatment course, he experienced dramatic relief of his TC and calciphylaxis.
Adult ; Blood Vessels ; Calcinosis* ; Calciphylaxis* ; Calcium ; Humans ; Hyperparathyroidism, Secondary ; Joints ; Kidney Failure, Chronic ; Leg ; Parathyroidectomy* ; Renal Dialysis ; Shoulder ; Sodium* ; Subcutaneous Fat ; Ulcer

Calciphylaxis is a rare disease that appear in patients with secondary hyper-parathyroidism or chronic renal failure or that show defect in calcium phosphate metabolism which is characterized by fibrin deposit or calcification of medial wall of vessels causing gradual ischemic skin necrosis. Calciphylaxis is a disease with poor prognosis as skin necrosis can progress rapidly. If left untreated, calciphylaxis will progress to sepsis with high mortality. The treatment is controversial but kidney transplantation or parathyroidectomy is suggested to recover calcium-phosphate metabolism. The authors have experienced calciphylaxis in a patient with chronic renal failure caused by DM nephropathy with characteristic skin lesion and rapid skin necrosis. We describe this case with documentary reviews.
Amputation ; Calciphylaxis ; Calcium ; Calcium Phosphates ; Diabetes Mellitus ; Diabetic Nephropathies ; Fibrin ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Leg ; Necrosis ; Parathyroidectomy ; Prognosis ; Rare Diseases ; Sepsis ; Skin

Calciphylaxis is a rare but life-threatening complication in patients with end stage renal disease (ESRD). Clinical presentation consists of violaceous skin lesions that progress to nonhealing ulcers and gangrene. Secondary infection of skin lesions is common, often leading to sepsis and death. We report a case presenting in 15months after maintenance hemodialysis for diabetic ESRD with painful violaceous skin discoloration on distal fingers of both hands and toes of left foot. X-ray of both hands and left foot showed vascular calcification along the course of the arteries. Despite symptomatic treatement, skin lesions progressed to nonhealing ulcers and became necrotic, and amputation of the second and fifth fingers of right hand was required. The surgical biopsy specimen revealed circumferential calcium deposition in the intima and media of the arteries by von Kossa stain. Two months after the operation, the patient died of cachexia.
Amputation ; Arteries ; Biopsy ; Cachexia ; Calciphylaxis* ; Calcium ; Coinfection ; Diabetes Mellitus ; Fingers ; Foot ; Gangrene ; Hand ; Humans ; Kidney Failure, Chronic* ; Renal Dialysis ; Sepsis ; Skin ; Toes ; Ulcer ; Vascular Calcification

Calciphylaxis has been described as a rare condition in patients with end-stage renal disease and secondary hyperparathyroidism. Selye et al. first coined the term calciphylaxis to describe soft-tissue calcification and cutaneous necrosis. The common manifestation include painful digital necrosis and medial calcification of small and medium sized vessels. Calciphylaxis is a clinical diagnosis and is characterized by painful, violaceous, mottled skin lesions. Radiographic studies reveal calcification of median and small vessels under the knee but vascular calcification is not specific for calciphylaxis. Histolopathologic findings show a markedly reduced lumen, secondary to the fibrin deposition and inflammation in and around the outer media with an outer ring of calcification which leads to progressive ischemic tissue necrosis. Kidney transplantation and parathyroidectomy is recommened but it is controversial. We present the case of a 64-years-old man with chronic renal failure as well as painful ischemic necrosis on the lower extremity. The pertinets literature is reviewed.
Calciphylaxis ; Diagnosis ; Fibrin ; Humans ; Hyperparathyroidism, Secondary ; Inflammation ; Kidney Failure, Chronic* ; Kidney Transplantation ; Knee ; Lower Extremity ; Necrosis ; Numismatics ; Parathyroidectomy ; Skin ; Vascular Calcification