- 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 |
SCVMC IM Chief Resident Blog 