A case of rapidly progressive unilateral non-nephrogenic hemorrhagic bullous calciphylaxis responding to systemic sodium thiosulfate therapy.

IF 1.4 4区医学 Q3 DERMATOLOGY Wounds : a compendium of clinical research and practice Pub Date : 2024-10-01

Rachel Wetstone, Rebecca Yim, Colleen Gabel, Kaitlyn Yim, Patrick O'Donnell, Fnu Nutan

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Abstract

Background: Calciphylaxis is a rare and life-threatening condition characterized by cutaneous necrosis resulting from vessel calcification and thrombosis. Commonly associated with end-stage renal disease and hyperparathyroidism, calciphylaxis presents as retiform purpura evolving into necrotic eschars.

Case report: This report details an atypical case of non-nephrogenic unilateral bullous calciphylaxis in a 71-year-old female, emphasizing the importance of considering calciphylaxis in the differential diagnosis of bullous disorders. The patient's presentation included hemorrhagic bullae on the left leg, prompting a challenging differential diagnosis. Diagnosis was confirmed by skin biopsy, highlighting the role of confirmatory biopsy in atypical cases such as this, with a broad differential diagnosis. Treatment involved intravenous sodium thiosulfate infusions and wound care, resulting in significant improvement after 6 months.

Conclusion: This case underscores the diagnostic complexity of bullous calciphylaxis, and clinicians are urged to consider this condition in patients with painful bullae and retiform purpura. Early recognition is crucial for initiating prompt intervention and improving outcomes in patients with this high-mortality disease.

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一例快速进展的单侧非肾源性出血性大疱性钙化症，对全身硫代硫酸钠治疗有反应。

背景：钙化病是一种罕见的危及生命的疾病，其特点是血管钙化和血栓形成导致皮肤坏死。钙铁病通常与终末期肾病和甲状旁腺功能亢进有关，表现为网状紫癜，并逐渐演变为坏死性疤痕：本报告详细介绍了一名 71 岁女性非肾源性单侧大疱性钙虹膜炎的非典型病例，强调了在大疱性疾病的鉴别诊断中考虑钙虹膜炎的重要性。患者的表现包括左腿出血性大疱，这给鉴别诊断带来了挑战。通过皮肤活检确诊了该病，这凸显了活检在非典型病例中的作用，因为此类病例的鉴别诊断范围很广。治疗包括静脉注射硫代硫酸钠和伤口护理，6 个月后病情明显好转：结论：本病例强调了大疱性钙化症诊断的复杂性，临床医生应在出现疼痛性大疱和网状紫癜的患者中考虑这种疾病。早期识别对于及时干预和改善这种高死亡率疾病患者的预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Wounds : a compendium of clinical research and practice 医学-皮肤病学

CiteScore

1.50

自引率

11.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Wounds is the most widely read, peer-reviewed journal focusing on wound care and wound research. The information disseminated to our readers includes valuable research and commentaries on tissue repair and regeneration, biology and biochemistry of wound healing, and clinical management of various wound etiologies. Our multidisciplinary readership consists of dermatologists, general surgeons, plastic surgeons, vascular surgeons, internal medicine/family practitioners, podiatrists, gerontologists, researchers in industry or academia (PhDs), orthopedic surgeons, infectious disease physicians, nurse practitioners, and physician assistants. These practitioners must be well equipped to deal with a myriad of chronic wound conditions affecting their patients including vascular disease, diabetes, obesity, dermatological disorders, and more. Whether dealing with a traumatic wound, a surgical or non-skin wound, a burn injury, or a diabetic foot ulcer, wound care professionals turn to Wounds for the latest in research and practice in this ever-growing field of medicine.