Calciphylaxis: Diagnostic and Treatment Advances for the Inpatient Dermatologist

Gowri Kabbur, Daniel D. Miller

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: Calciphylaxis is a rare, life-threatening condition that frequently requires inpatient dermatology management. This article provides a comprehensive overview of the risk factors, classification, and pathogenesis of calciphylaxis, and summarizes current evidence for diagnostic testing and multi-disciplinary therapeutic management. Recent Findings: The two major subtypes of calciphylaxis tend to present in different anatomic locations, with non-uremic lesions favoring the distal extremities. Skin biopsies obtained on the distal extremities are more sensitive in detecting calciphylaxis-related vascular calcifications, compared to other sites. Underlying hypercoagulable disorders are common among calciphylaxis patients, implicating thrombosis as a major mediator of this disease and highlighting the potential therapeutic role of anticoagulants. Summary: Calciphylaxis is a challenging condition to treat, requiring multi-disciplinary care from dermatology, nephrology, pain medicine, plastic/general surgery, and palliative care. Inpatient dermatologists should be aware of the risk factors associated with calciphylaxis and focus therapy with pharmacologic agents and local wound care.

Original languageEnglish (US)
Pages (from-to)244-255
Number of pages12
JournalCurrent Dermatology Reports
Volume9
Issue number4
DOIs
StatePublished - Dec 2020

Keywords

  • Calcific uremic arteriolopathy
  • Calciphylaxis
  • Hypercoagulable disorders
  • Retiform purpura
  • Vascular calcifications
  • Wound care

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