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Correspondence |

Calciphylaxis Associated With Chronic Inflammatory Conditions, Immunosuppression Therapy, and Normal Renal Function: A Report of 2 Cases

Allison M. Swanson, MD; Seemal R. Desai, MD; Jeremy D. Jackson, MD; Aleodor A. Andea, MD; Lauren C. Hughey, MD
Arch Dermatol. 2009;145(6):723-725. doi:10.1001/archdermatol.2009.103.
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Calciphylaxis is a syndrome of vascular calcification and skin necrosis commonly associated with chronic renal failure. We present 2 cases of calciphylaxis in patients with chronic inflammatory conditions and immunosuppression but normal renal function.

Gipstein  RMCoburn  JWAdams  DA  et al.  Calciphylaxis in man: a syndrome of tissue necrosis and vascular calcification in 11 patients with chronic renal failure. Arch Intern Med 1976;136 (11) 1273- 1280
PubMed
Goli  AKGoli  SAShah  LSByrd  RP  JrRoy  TM Calciphylaxis: a rare association with alcoholic cirrhosis: are deficiencies in protein C and S the cause? South Med J 2005;98 (7) 736- 739
PubMed
Korkmaz  CDundar  EZubaroglu  I Calciphylaxis in a patient with rheumatoid arthritis without renal failure and hyperparathyroidism: the possible role of long-term steroid use and protein S deficiency. Clin Rheumatol 2002;21 (1) 66- 69
PubMed
Arseculeratne  GEvans  ATMorley  SM Calciphylaxis: a topical overview. J Eur Acad Dermatol Venereol 2006;20 (5) 493- 502
PubMed
Weenig  RH Pathogenesis of calciphylaxis: Hans Selye to nuclear factor kappa-B. J Am Acad Dermatol 2008;58 (3) 458- 471
PubMed
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Figure 1.

Clinical (A) and histopathologic (B) images from case 1. A, Violaceous plaque containing necrotic, punched-out ulcerations on the right lower extremity. B, Medium-sized deep-dermal vessel exhibiting medial calcification accompanied by luminal narrowing (hematoxylin-eosin, original magnification ×200).

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Figure 2.

Clinical (A) and histopathologic (B) images from case 2. A, Necrotic ulcer on the lower leg. B, Small artery within the subcutis with circumferential calcification of the media (arrow) and intimal fibrosis (hematoxylin-eosin, original magnification ×100).

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