5/18/16 AM Report – Calciphylaxis

  • Think about calciphylaxis in your ESRD patients with non-healing ulcers in areas of adiposity (abdomen, buttocks, thighs, legs)
  • Biopsy shows arterial calcifications without vasculitis
  • Often associated with elevated PTH levels and elevated calcium-phosphorous product, hypoalbuminemia
  • Check out this UCSF resident hand-out on calciphylaxis!
  • We had a great review of features of chronic venous stasis including lipodermatosclerosis (inverted champagne bottle), atrophie blanche, telangiectasias, ulcerations on the medial ankles.
  • See the table below for comparison/contrast of arterial versus venous ulcers
Venous Arterial
Pathophysiology Reflux and Venous stasis, faulty valves Atherosclerosis, embolic
Skin Findings Lipodermatosclerosis (inverted champagne bottle)

Atrophie Blanche

Telangiectasias

Hyperpigmentation

Warm

Hairless

Pale, Shiny, Taut

Cold

Ulcers Shallow, superficial, irregular borders Punched out, deep, full thickness wounds
Pain Less painful usually, improves with leg elevation Severe pain, improves with lowering legs
Ulcer Location Medial and lateral malleolar Above bony prominences, pressure points, base of heel

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