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A Journal on Dermatology and Sexually Transmitted Diseases

Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2013 October;148(5):531-6

language: English

Calciphylaxis in dialysis patients, a severe disease poorly responding to therapies: report of 4 cases

Savoia F. 1, Gaddoni G. 1, Patrizi A. 2, Misciali C. 2, Odorici G. 2, Tampieri G. 3, Tampieri E. 3, Cantelli S. 3, Aldi M. 4

1 Unit of Dermatology, AUSL Ravenna, Ravenna, Italy;
2 Department of Internal Medicine Geriatrics and Nephrology, Division of Dermatology, University of Bologna, Bologna, Italy;
3 Unit of Nephrology, AUSL Ravenna, Ravenna, Italy;
4 Unit of Pathologic Anatomy AUSL Ravenna, Ravenna, Italy


Calciphylaxis or calciphic uremic arteriolopathy (CUA) is a rare syndrome characterized by the deposition of calcium within the walls of small and medium size vessels in the dermis and in the subcutaneous tissue. The disease mainly affects patients with end-stage renal disease. We report here our experience with 4 cases of calciphylaxis in dialysis patients. The main predisposing factor observed in our 4 patients was warfarin use (2 patients, 50%), while local traumas and diabetes were respectively present in only one patient. None of our patients was obese. Lower legs were the most frequently involved site of CUA (3/4 patients, 75%). In our experience biopsy was crucial to achieve a correct diagnosis and did not cause aggravation of the ulcers. Therapeutic approach was multimodal: mainly hyperbaric oxygen therapy, cinacalcet and sodium thiosulphate. Although many recent case reports have shown exceptional results and healing with the use of sodium thiosulphate, we did not experience any change in the poor prognosis of our patients with the use of this drug, at a dosage of 5 g thrice weekly endovenously.

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