Calciphylaxis - Revision history

Rossdonaldson1: /* Background */

2024-12-11T16:18:00Z

Background

← Revisión anterior		Revisión del 16:18 11 dic 2024
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	==Background==		==Background==
			{{Skin anatomy background images}}
	*Most commonly seen in [[ESRD]] patients on [[hemodialysis]] (~1%)		*Most commonly seen in [[ESRD]] patients on [[hemodialysis]] (~1%)
	**Seen almost exclusively in patients with Stage 5 chronic kidney disease		**Seen almost exclusively in patients with Stage 5 chronic kidney disease

ClaireLewis at 20:32, 27 September 2019

2019-09-27T20:32:57Z

← Revisión anterior		Revisión del 20:32 27 sep 2019
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	==Background==		==Background==
	*Most commonly seen in ESRD patients on hemodialysis (~1%)		*Most commonly seen in [[ESRD]] patients on [[hemodialysis]] (~1%)
	**Seen almost exclusively in patients with Stage 5 chronic kidney disease		**Seen almost exclusively in patients with Stage 5 chronic kidney disease
	*No available data in general population (non-uremic calciphylaxis)		*No available data in general population (non-uremic calciphylaxis)
	*Calcium and phosphate levels rise beyond solubility and precipitate in arteries		*[[hypercalcemia\|Calcium]] and [[hyperphosphatemia\|phosphate]] levels rise beyond solubility and precipitate in arteries
	*May be increasing due to widespread IV vitamin D		*May be increasing due to widespread IV vitamin D
	*Mortality as high as 60-80%; [[sepsis]] from necrotic skin lesions		*Mortality as high as 60-80%; [[sepsis]] from necrotic skin lesions

	==Clinical Features==		==Clinical Features==
	*Very painful lesions develop suddenly and progress rapidly		*Very painful [[rash\|lesions]] develop suddenly and progress rapidly
	*~~Dermatolgic~~ appearances:		*Dermatologic appearances:
	**Livedo reticularis		**Livedo reticularis
	**Stellate purpura		**Stellate purpura
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	**Calcimimetics in hyperparathyroidism		**Calcimimetics in hyperparathyroidism
	**Bisphosphonates		**Bisphosphonates
	**Sodium thiosulfate - off-label, increases solubility of calcium deposits		**[[Sodium thiosulfate]] - off-label, increases solubility of calcium deposits
	**Fix hypercoagulability		**Fix hypercoagulability
	**Surgical		**Surgical

Rossdonaldson1 at 20:40, 20 March 2017

2017-03-20T20:40:02Z

← Revisión anterior		Revisión del 20:40 20 mar 2017
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	*Calcium and phosphate levels rise beyond solubility and precipitate in arteries		*Calcium and phosphate levels rise beyond solubility and precipitate in arteries
	*May be increasing due to widespread IV vitamin D		*May be increasing due to widespread IV vitamin D
	*Mortality as high as 60-80%; sepsis from necrotic skin lesions		*Mortality as high as 60-80%; [[sepsis]] from necrotic skin lesions

	==Clinical Features==		==Clinical Features==
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	**Livedo reticularis		**Livedo reticularis
	**Stellate purpura		**Stellate purpura
	**Usually ~~LEs~~, hands, or torso		**Usually lower extremities, hands, or torso

	==Differential Diagnosis==		==Differential Diagnosis==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-23T14:40:30Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 14:40 23 jul 2016
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	{{ESRD Associated Skin Conditions}}		{{ESRD Associated Skin Conditions}}

	==~~Diagnosis~~==		==Evaluation==
	===Labs===		===Labs===
	*Serum PTH level		*Serum PTH level

Kxl328: /* Diagnosis */

2016-05-05T14:03:52Z

Diagnosis

← Revisión anterior		Revisión del 14:03 5 may 2016
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	*Plain radiographs - arborization of vascular calcification within dermis and subQ tissues		*Plain radiographs - arborization of vascular calcification within dermis and subQ tissues
	*Ultrasound may aid in examining for vascular calcification<ref>Bukhman R et al. Sonography in the Identification of Calciphylaxis of the Breast. JUM January 1, 2010 vol. 29 no. 1 129-133.</ref>		*Ultrasound may aid in examining for vascular calcification<ref>Bukhman R et al. Sonography in the Identification of Calciphylaxis of the Breast. JUM January 1, 2010 vol. 29 no. 1 129-133.</ref>

			===Biopsy<ref>Nigwekar SU et al. Calciphylaxis: Risk Factors, Diagnosis, and Treatment. Am J Kidney Dis. 2015;66(1):133-146.</ref>===
			*Definitive means of diagnosis
			*Punch biopsy from lesion margin by dermatologist or wound surgeon
			*Caution in non-ulcerated/necrotic lesions as biopsy site has high likelihood of not healing in true calciphylaxis

	==Management==		==Management==

Kxl328 at 21:51, 2 May 2016

2016-05-02T21:51:11Z

← Revisión anterior		Revisión del 21:51 2 may 2016
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	===Imaging===		===Imaging===
	*Plain radiographs - arborization of vascular calcification within dermis and subQ tissues		*Plain radiographs - arborization of vascular calcification within dermis and subQ tissues
			*Ultrasound may aid in examining for vascular calcification<ref>Bukhman R et al. Sonography in the Identification of Calciphylaxis of the Breast. JUM January 1, 2010 vol. 29 no. 1 129-133.</ref>

	==Management==		==Management==

Ostermayer: Text replacement - "Category:Derm" to "Category:Dermatology"

2016-03-22T13:13:26Z

Text replacement - "Category:Derm" to "Category:Dermatology"

← Revisión anterior		Revisión del 13:13 22 mar 2016
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	[[Category:FEN]]		[[Category:FEN]]
	[[Category:~~Derm~~]]		[[Category:Dermatology]]

Rossdonaldson1: /* See Also */

2015-07-27T03:37:57Z

Rossdonaldson1: /* Differential Diagnosis */

2015-07-27T03:37:11Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
	*Brown recluse spider bite		*[[Brown recluse spider bite]]
	*Bullous ~~Pemphigoid~~		*[[Bullous pemphigoid]]
	*Cellulitis, necrotizing fasciitis		*[[Cellulitis]], [[necrotizing fasciitis]]
	*Erythema ~~Nodosum~~		*[[Erythema nodosum]]
	*Vasculitis		*[[Vasculitis]]
	*Venous ulcers		*[[Venous ulcers]]
	*[[Hypercalcemia]]		*[[Hypercalcemia]]
	*[[Hyperphosphatemia]]		*[[Hyperphosphatemia]]

Rossdonaldson1: /* Differential Diagnosis */

2015-07-27T03:36:30Z

Differential Diagnosis

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	*[[Hypercalcemia]]		*[[Hypercalcemia]]
	*[[Hyperphosphatemia]]		*[[Hyperphosphatemia]]
	*Nephrogenic systemic fibrosis (MRI w/ gadolinium in dialysis pt)
			{{ESRD Associated Skin Conditions}}

	==Diagnosis==		==Diagnosis==

← Revisión anterior		Revisión del 03:37 27 jul 2015
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	==See Also==		==See Also==
	[[Dialysis complications]]		*[[Dialysis complications]]

	==References==		==References==