Calciphylaxis

Risk factors

Activating factors

Impaired vascular status

Hypovolemic shock, hypotension, vasoconstriction

Obesity

Cardiac insufficiency, infection, hyperviscosity

Diabetes mellitus

Local injury, injection, local pressure

Female

Hemostasis perturbations

Antivitamin K therapy

Elevated blood level of calcium and phosphate

Impaired bone mineralization

Hypercalcemia

Hyperphosphatemia

Hyperparathyroidy

Dialysis

The cutaneous involvement may be associated with systemic necrosis (myocardium, bowel, nervous system, pulmonary system, etc.).

Semiology: Painful and extensive skin necrosis, mainly associated with a livedoid aspect and often located in the abdomen and low extremities (Fig. 25.1a, b).

Fig. 25.1
Leg and abdominal involvement with ulceration and livedoid aspect
Biology: Presence or absence of hyperparathyroidism, coagulopathy, and disorders related to underlying conditions [3, 4].
Histology: One observe a transdifferentiation of the vascular muscle cells to osteoblastic-like cells causing extensive calcifications (vascular, muscular, and cutaneous involvements). Calcium deposition in the vascular walls and intraluminal thrombi can be found.

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