Calciphylaxis - a challenging & solvable task for plastic surgery? A case report

BMC Dermatol. 2013 Jan 14:13:1. doi: 10.1186/1471-5945-13-1.

Abstract

Background: Calciphylaxis (calcific uremic arteriolopathy) is rare and its pathogenesis is not fully understood. Indeed, Calciphylaxis presents a challenge through the course of its management which involve different specialities but unfortunately this disease so far has a poor prognosis. We herein present, in this case report, a multidisciplinary approach involving plastic surgeons with special regards to reconstructive approach after debridement procedures.

Case presentation: We present a 21 years old male with a BMI of 38,2, who was transferred to our department from another hospital. Calciphylaxis has been diagnosed after receiving anticoagulation with phenprocoumon after a single event of pulmonary embolism. The INR on admission was 1,79. He had necrotic spots on both sides of the abdominal wall and on both thighs medially. During this time he underwent several reconstructive procedures in our department.

Conclusion: It can be suggested that this agonizing disease needs indeed a multidisciplinary approach involving Nephrologists, Dermatologists, Intensive Care Physicians and Plastic Surgeons, taking into consideration that surgical correction can achieve further improvement in a specialized centre. Notwithstanding, further cohort studies should be approached clinically to insight the light on this disease with special regard to the prognosis after this approach.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Wall
  • Adult
  • Anticoagulants / adverse effects
  • Calciphylaxis / chemically induced*
  • Calciphylaxis / surgery*
  • Humans
  • Male
  • Phenprocoumon / adverse effects*
  • Plastic Surgery Procedures / methods*
  • Pulmonary Embolism / drug therapy
  • Skin Transplantation / methods*
  • Thigh
  • Young Adult

Substances

  • Anticoagulants
  • Phenprocoumon