A Helpful Clue to Calciphylaxis: Subcutaneous Pseudoxanthoma Elasticum-like Changes
Calciphylaxis, otherwise known as calcific uremic arteriolopathy, is an aggressive disease characterized by painful, ischemic skin lesions with histologic findings of microvascular calcification involving the fat. It is most commonly seen in patients with end-stage renal disease who are on dialysis....
Saved in:
Published in | The American journal of dermatopathology Vol. 42; no. 7; p. 521 |
---|---|
Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
United States
01.07.2020
|
Subjects | |
Online Access | Get more information |
Cover
Loading…
Abstract | Calciphylaxis, otherwise known as calcific uremic arteriolopathy, is an aggressive disease characterized by painful, ischemic skin lesions with histologic findings of microvascular calcification involving the fat. It is most commonly seen in patients with end-stage renal disease who are on dialysis. Early diagnosis is pivotal for optimal management. However, calciphylaxis can be challenging to diagnose, as many diseases can bear a clinical resemblance to calciphylaxis. Skin biopsies are often necessitated for diagnosis, but unfortunately, one is commonly challenged with a suboptimal amount of subcutaneous fat that does not always show the classic findings of microvascular calcification. However, when calciphylaxis is clinically suspected, the microscopic detection of subcutaneous pseudoxanthoma elasticum (PXE)-like changes, although not unequivocally diagnostic of calciphylaxis, can be a helpful clue in the diagnosis. We report a case of a 49-year-old woman who was diagnosed with uremic calciphylaxis on the basis of the clinical scenario, laboratory testing, and microscopic presence of subcutaneous PXE-like changes that was highlighted with the elastic and von Kossa stains. This case demonstrates the importance of recognizing subcutaneous PXE-like changes on suboptimal skin biopsies that lack microvascular calcification, especially in those patients who are clinically suspect for calciphylaxis as to prevent delay in diagnosis and treatment. |
---|---|
AbstractList | Calciphylaxis, otherwise known as calcific uremic arteriolopathy, is an aggressive disease characterized by painful, ischemic skin lesions with histologic findings of microvascular calcification involving the fat. It is most commonly seen in patients with end-stage renal disease who are on dialysis. Early diagnosis is pivotal for optimal management. However, calciphylaxis can be challenging to diagnose, as many diseases can bear a clinical resemblance to calciphylaxis. Skin biopsies are often necessitated for diagnosis, but unfortunately, one is commonly challenged with a suboptimal amount of subcutaneous fat that does not always show the classic findings of microvascular calcification. However, when calciphylaxis is clinically suspected, the microscopic detection of subcutaneous pseudoxanthoma elasticum (PXE)-like changes, although not unequivocally diagnostic of calciphylaxis, can be a helpful clue in the diagnosis. We report a case of a 49-year-old woman who was diagnosed with uremic calciphylaxis on the basis of the clinical scenario, laboratory testing, and microscopic presence of subcutaneous PXE-like changes that was highlighted with the elastic and von Kossa stains. This case demonstrates the importance of recognizing subcutaneous PXE-like changes on suboptimal skin biopsies that lack microvascular calcification, especially in those patients who are clinically suspect for calciphylaxis as to prevent delay in diagnosis and treatment. |
Author | Braniecki, Marylee Chen, Eric L Altman, Igor |
Author_xml | – sequence: 1 givenname: Eric L surname: Chen fullname: Chen, Eric L organization: Department of Pathology, University of Illinois College of Medicine, Chicago, IL – sequence: 2 givenname: Igor surname: Altman fullname: Altman, Igor – sequence: 3 givenname: Marylee surname: Braniecki fullname: Braniecki, Marylee |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31789837$$D View this record in MEDLINE/PubMed |
BookMark | eNpNj9tKAzEURYMo9qJ_IJIfmJrkEJPxbZi2VigoVJ_LyWWc0cyFZgLt3yuo4H5ZsB4W7Bk57_rOE3LD2YKzXN0ti-WC_RuXSp2RKZcAGQPOJ2QW48e3F5rJSzIBrnSuQU3JrqAbH4YqBVqG5OnY0xKDbYb6FPDYxAe6S8amETvfp0hfok-uP2I31n2LdBUwjo1NbRaaT0_LGrt3H6_IRYUh-utfzsnbevVabrLt8-NTWWwzC0yNmfRC6kpbZEqDrUDwCo3RYLg3eZ4zUCC1vM-ZUxoNOgFGO-Y8eGskE07Mye1Pd0im9W4_HJoWD6f93zvxBcP9Uww |
CitedBy_id | crossref_primary_10_1007_s13671_020_00316_z crossref_primary_10_1016_j_adengl_2021_07_003 crossref_primary_10_1007_s11255_020_02424_y crossref_primary_10_1016_j_ad_2020_08_014 crossref_primary_10_1111_cup_14234 crossref_primary_10_1016_j_jaad_2021_10_064 crossref_primary_10_1038_s41598_023_42492_5 |
ContentType | Journal Article |
DBID | CGR CUY CVF ECM EIF NPM |
DOI | 10.1097/DAD.0000000000001577 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) |
DatabaseTitleList | MEDLINE |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | no_fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1533-0311 |
ExternalDocumentID | 31789837 |
Genre | Journal Article Case Reports |
GroupedDBID | --- .-D .3C .GJ .Z2 0R~ 123 23M 3O- 4Q1 4Q2 4Q3 53G 5RE 5VS 6J9 8L- AAAAV AAHPQ AAIQE AAMTA AARTV AASCR ABASU ABBUW ABDIG ABJNI ABKPX ABVCZ ABXVJ ABZAD ACDDN ACEWG ACGFO ACGFS ACILI ACNWC ACWDW ACWRI ACXJB ACXNZ ADFPA ADGGA ADHPY ADNKB AE3 AE6 AEETU AENEX AFDTB AFFNX AFUWQ AHQNM AHRYX AHVBC AI. AINUH AJIOK AJNWD AJNYG AJZMW ALMA_UNASSIGNED_HOLDINGS ALMTX AMJPA AMKUR AMNEI AOHHW AWKKM BQLVK BS7 C45 CGR CS3 CUY CVF DIWNM DUNZO E.X EBS ECM EEVPB EIF EJD EX3 F2K F2L F5P FCALG FL- GNXGY GQDEL H0~ HLJTE HZ~ IKREB IN~ IPNFZ J5H JF9 JG8 JK3 JK8 K8S KD2 KMI L-C N9A NPM N~M O9- OAG OAH OCUKA ODA OJAPA OL1 OLG OLV OLW OLZ OPUJH ORVUJ OUVQU OVD OVDNE OWU OWV OWW OWX OWY OWZ OXXIT P-K P2P R58 RIG RLZ S4R S4S T8P TEORI TSPGW V2I VH1 W3M WOQ WOW X3V X3W XXN XYM YOC ZFV ZGI ZXP ZZMQN |
ID | FETCH-LOGICAL-c307t-5e258f8ca0783cf321fabb83b1eb9990373585690d78abad23b8d0de3ecb502d2 |
IngestDate | Sat Sep 28 08:29:08 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 7 |
Language | English |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c307t-5e258f8ca0783cf321fabb83b1eb9990373585690d78abad23b8d0de3ecb502d2 |
PMID | 31789837 |
ParticipantIDs | pubmed_primary_31789837 |
PublicationCentury | 2000 |
PublicationDate | 2020-Jul |
PublicationDateYYYYMMDD | 2020-07-01 |
PublicationDate_xml | – month: 07 year: 2020 text: 2020-Jul |
PublicationDecade | 2020 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States |
PublicationTitle | The American journal of dermatopathology |
PublicationTitleAlternate | Am J Dermatopathol |
PublicationYear | 2020 |
SSID | ssj0012805 |
Score | 2.332522 |
Snippet | Calciphylaxis, otherwise known as calcific uremic arteriolopathy, is an aggressive disease characterized by painful, ischemic skin lesions with histologic... |
SourceID | pubmed |
SourceType | Index Database |
StartPage | 521 |
SubjectTerms | Calciphylaxis - diagnosis Calciphylaxis - pathology Female Humans Middle Aged Subcutaneous Tissue - pathology |
Title | A Helpful Clue to Calciphylaxis: Subcutaneous Pseudoxanthoma Elasticum-like Changes |
URI | https://www.ncbi.nlm.nih.gov/pubmed/31789837 |
Volume | 42 |
hasFullText | |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1ba9swFBbpBqUvY_etu6CHvRVttiVZ8t68tKMbpAyWQt-KJEsj1IlD64x2v35HtpwqXQfd_GCMBSbofPn8neNzQeidM4xVrBCkEFYSxk1GVCIdMUomwoGA1c5XI0-O8sNj9vWEn4xGP6OspVWr35tft9aV_I9V4R7Y1VfJ_oNl1w-FG3AN9oUzWBjOd7Jx6d8aS59lPK5X3QyMsarNDHauVpezLtkNiMGsQABan-r67cKuquZS-YYBc7V3AMrZ996Yk3p2ZkOhwUUsV6fXdSeLuMlE5fm8bfw4442w_DjUenh23VuHlcu6DXHWLz-adTLwp3Nf3W76sdkTdX5VWxvHIMDhHPJV4RUy8CYlwA9pTKwsiwAkIpbkfVH0H-zddwXeL_f7rpLhSHk_6CUy6HLeWRS0jywkvcPqjZ7aw9IW2hLS8-KRj_GEb0-ZTPhQZFmID7f9nB20PTzihjvSyZLpQ_Qg-BO47MHxCI3s4jHanoSMiSfoe4kDRrDHCG4bvIGRjzhGCN5ECN5ECA4IeYqOPx9Mx4ckDNIgBii8JdxmXDpplP9maxzNUqe0llSnVoODkFBBwWvMi6QSUmlVZVTLKqkstUbzJKuyZ-jeolnYFwg7ljNQnEYYUNJKSG0ZKEabGyNoynPxEj3vt-N02XdLOR02avevK6_QzjWoXqP7Dv6e9g1ovVa_7UzzG6TCUv0 |
link.rule.ids | 786 |
linkProvider | National Library of Medicine |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=A+Helpful+Clue+to+Calciphylaxis%3A+Subcutaneous+Pseudoxanthoma+Elasticum-like+Changes&rft.jtitle=The+American+journal+of+dermatopathology&rft.au=Chen%2C+Eric+L&rft.au=Altman%2C+Igor&rft.au=Braniecki%2C+Marylee&rft.date=2020-07-01&rft.eissn=1533-0311&rft.volume=42&rft.issue=7&rft.spage=521&rft_id=info:doi/10.1097%2FDAD.0000000000001577&rft_id=info%3Apmid%2F31789837&rft_id=info%3Apmid%2F31789837&rft.externalDocID=31789837 |