Skin nontumor



Last author update: 1 July 2011
Last staff update: 28 August 2020

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PubMed Search: Calciphylaxis [title]

Mowafak Hamodat, M.B.Ch.B., M.Sc.
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Cite this page: Hamodat M. Calciphylaxis. website. Accessed September 21st, 2023.
Definition / general
  • Rare, life threatening condition of progressive cutaneous necrosis due to small and medium sized vessel calcification
  • Also called calcifying panniculitis or vascular calcification-cutaneous necrosis syndrome
  • Due to primary, secondary or tertiary hyperparathyroidism and associated elevated calcium and phosphate levels, which exceed their solubility and deposit in vessels, causing progressive vascular compromise in skin and subcutaneous fat and less often muscle
Clinical features
  • Lesions are bilateral and symmetric, pruritic and frequently painful / tender
  • Often lower extremity, with preservation of pulses
  • Less often affects the breast, abdomen and penis
  • Mortality rate up to 60%
Case reports
  • Surgical removal of autonomous parathyroid gland (if due to primary hyperparathyroidism)
  • Also hyperbaric oxygen, antihistamines, corticosteroids
Clinical images

Images hosted on other servers:

Necrosis resembling a burn injury

Calciphylaxis on
abdomen of patient
with end stage
renal disease

Microscopic (histologic) description
  • Involves intima and media of large and small blood vessels
  • Deposits are associated with thrombi
  • Intimal fibroblastic proliferation with luminal narrowing has also been described
  • Also hemorrhage within the subcutaneous fat, fat necrosis accompanied by lobular lymphohistiocytic infiltrate
  • Interstitial calcification is rare
  • Pseudoxanthoma elasticum like changes may occur
Microscopic (histologic) images

Contributed by Sepideh N. Asadbeigi, M.D.

Calcium deposits

Calcium deposits in deep dermis

involving small
blood vessels with
associated thrombi

Subcutaneous fat with vascular calcium deposits

Differential diagnosis
  • Metastatic calcification: due to hyperparathyroidism or chronic renal failure
  • Dystrophic calcinosis cutis: deposits in areas of previously abnormal skin
  • Tumoral calcinosis: no known cause
  • Idiopathic calcinosis of scrotum
  • Subepidermal calcified nodule: childhood papule, small, fleshy, firm, on face
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