PMC222929_01
Calciphylaxis cutis on admission. After transfer to the dermatologic department, about 1 month after first incidence of a calciphylactic ulcer of the lower right leg.
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F1
While a single, 2.5-cm ulcer closed, other ulcerations appeared at the right calf (Figure 1).
Calciphylaxis cutis, 2 months after admission. Large ulcerations at both lower legs with signs of superinfection.
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F2
Despite wound care on a daily basis both in hospital and in ambulatory care, the cutaneous ulcers worsened. 2 months after first admission, the patient was readmitted because of exacerbated ulcers on both lower legs (Figure 2).
Calciphylaxis cutis, 4 months after admission. Size enlargement of calciphylactic ulcerations. Maggot debridement therapy abolished superinfection to a large extent.
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F3
Following four courses, the wounds gradually improved, granulated and showed signs of healing, yet the large extent of those wounds remained, rendering the patient at high risk of reinfection (Figure 3).
Calcifications of skin arteries, arterioles and capillaries. Biopsy and autopsy revealed calcifications of small arteries, arterioles and capillaries within the ulcerated skin.
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F4
The diagnosis of Calciphylaxis cutis was confirmed by autopsy, revealing small- and medium-sized blood-vessel calcifications within the ulcerated skin of the lower legs as previously seen in the biopsy (Figure 4 and 5).
Calcifications of skin arteries, arterioles and capillaries. Biopsy and autopsy revealed calcifications of small arteries, arterioles and capillaries within the ulcerated skin.
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F5
The diagnosis of Calciphylaxis cutis was confirmed by autopsy, revealing small- and medium-sized blood-vessel calcifications within the ulcerated skin of the lower legs as previously seen in the biopsy (Figure 4 and 5).
Calcifications of the left atrial wall of the heart. Autopsy revealed calcifications and endocardial fibrosis within the wall of the left atrium.
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F6
Unusual locations of calcifications were the wall of the left atrium of the heart (Figure 6) and pulmonary arteries.