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Calciphylaxis Responding to Sodium Thiosulfate Therapy

Brian L. Baker, MD; Carrie A. Fitzgibbons, BS; Lucinda S. Buescher, MD
Arch Dermatol. 2007;143(2):264-276. doi:10.1001/archderm.143.2.269.
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Calciphylaxis is an uncommon and extremely painful calcifying panniculitis, most often seen in patients with end-stage renal disease. The prognosis is poor, with a 6-month mortality rate ranging from 33% to 80%.1 Dermatologists are often called on to diagnose the condition, but unfortunately, successful treatments have not been available. We describe a case that responded to treatment with sodium thiosulfate.

Fine  AZacharias  J Calciphylaxis is usually non-ulcerating: risk factors, outcome and therapy. Kidney Int 2002;612210- 2217
PubMed Link to Article[[XSLOpenURL/10.1046/j.1523-1755.2002.00375.x]]
National Kidney Foundation, K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39S1- S266
PubMed
Cicone  JSPetroonis  JBEmbert  CDSpector  D Successful treatment of calciphylaxis with intravenous sodium thiosulfate. Am J Kidney Dis 2004;431104- 1108
PubMed Link to Article[[XSLOpenURL/10.1053/j.ajkd.2004.03.018]]
Guerra  FShah  RCRoss  EA Rapid resolution of calciphylaxis with intravenous sodium thiosulfate and continuous venovenous haemofiltration using low calcium replacement fluid: case report. Nephrol Dial Transplant 2005;201260- 1262
Link to Article[[XSLOpenURL/10.1093/ndt/gfh825]]
Hayden  MRTyagi  SCKold  LSowers  JKhanna  R Vascular ossification-calcification in metabolic syndrome, type 2 diabetes mellitus, chronic kidney disease, and calciphylaxis-calcific uremic arteriolopathy: the emerging role of sodium thiosulfate. Cardiovasc Diabetol 2005;44
PubMed Link to Article[[XSLOpenURL/10.1186/1475-2840-4-4]]
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Figure 1.

Indurated, depressed plaque with necrotic ulceration and eschar on the patient's left lateral thigh.

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Figure 2.

Photomicrograph of lesion biopsy specimen from left lateral thigh.

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Figure 3.

Residual scar tissue.

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