Calciphylaxis
Description
- Calcific uraemic arteriolopathy - medial calcification + intimal fibrosis of dermal/subcutaneous arterioles -> thrombosis -> ischaemic panniculitis and skin necrosis
- A vascular occlusive disease, not a calcium-deposition disease - serum calcium and phosphate are frequently normal
- Two patterns:
- Central/proximal (abdomen, buttock, thigh) - adipose-rich, worse prognosis
- Distal/acral (calf, ankle, digits) - better prognosis
- Non-uraemic calciphylaxis exists (~5-10%) - normal renal function; think primary hyperparathyroidism, malignancy, warfarin, autoimmune disease, POEMS
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