Calciphylaxis: Difference between revisions
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**Usually LEs, hands, or torso | **Usually LEs, hands, or torso | ||
== | ==Differential Diagnosis== | ||
*Brown recluse spider bite | *Brown recluse spider bite | ||
*Bullous Pemphigoid | *Bullous Pemphigoid | ||
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*Vasculitis | *Vasculitis | ||
*Venous ulcers | *Venous ulcers | ||
*[[Hypercalcemia]] | |||
*[[Hyperphosphatemia]] | |||
==Labs== | ==Diagnosis== | ||
===Labs=== | |||
*Serum PTH level | *Serum PTH level | ||
*CBC, CMP, phosphate, coags | *CBC, CMP, phosphate, coags | ||
*Inpatient - hepatitis panel, cryofibrinogen level, lipase, ESR, CRP, ANA, ANCA | *Inpatient - hepatitis panel, cryofibrinogen level, lipase, ESR, CRP, ANA, ANCA | ||
==Imaging== | ===Imaging=== | ||
*Plain radiographs - arborization of vascular calcification within dermis and subQ tissues | *Plain radiographs - arborization of vascular calcification within dermis and subQ tissues | ||
== | ==Management== | ||
*Medical | *Medical | ||
[[Category:FEN]] | |||
[[Category:Derm]] | |||
Revision as of 16:37, 21 November 2014
Background
- Most commonly HD/ESRD patients (1% of ESRD)
- No available data in general population (non-uremic calciphylaxis)
- Calcium and phosphate levels rise beyond solubility and precipitate in arteries
- May be increasing due to widespread IV vitamin D
- Mortality as high as 60-80%; sepsis from necrotic skin lesions
Features
- Very painful lesions develop suddenly and progress rapidly
- Dermatolgic appearances:
- Livedo reticularis
- Stellate purpura
- Usually LEs, hands, or torso
Differential Diagnosis
- Brown recluse spider bite
- Bullous Pemphigoid
- Cellulitis, necrotizing fasciitis
- Erythema Nodosum
- Vasculitis
- Venous ulcers
- Hypercalcemia
- Hyperphosphatemia
Diagnosis
Labs
- Serum PTH level
- CBC, CMP, phosphate, coags
- Inpatient - hepatitis panel, cryofibrinogen level, lipase, ESR, CRP, ANA, ANCA
Imaging
- Plain radiographs - arborization of vascular calcification within dermis and subQ tissues
Management
- Medical