Penile Calciphylaxis in an Elderly man with End-Stage Renal Disease

Computed tomography scan revealed diffuse vascular calcification including the penile arteries.Source: Journal of Medical Case Reports

Calciphylaxis is a rare, often life-threatening skin disorder. It usually occurs in patients with end-stage renal disease. It results from the calcification of small blood vessels in the adipose and dermal tissue. Moreover, this disorder presents with painful necrotic lesions that are difficult to heal.

Necrosis of the glans with overlying purulence. Source: Journal of Medical Case Reports

Case Presentation

This article describes the case of a penile calciphylaxis in a 73-year-old man with a history of end-stage renal disease. He presented to the hospital with complaints of necrotic, worsening ulcers on the glans penis and distal digits for 2 months. He had associated co-morbidities, which were, coronary artery disease, hypertension, and diabetes. However, he had no history of smoking or trauma.

The doctors performed a physical examination which revealed several small necrotic ulcers along with foul-smelling, purulent lesions on the glans penis. The examination was normal otherwise. Moreover, the lesions on his penis were previously treated with oral amoxicillin-clavulanic acid but no improvement was seen.

CT Scan Revealed Calciphylaxis

On further evaluation, the doctors performed laboratory tests that showed elevated calcium and phosphate levels. Along with this, the computed tomography (CT) scan of the abdomen and pelvis revealed diffuse intravascular calcification. These findings on scan, elevated calcium and phosphate levels were significant for calciphylaxis. 

Treatment Prognosis

Initially, the doctors treated the patient with sodium thiosulfate thrice a week but it had no recovery. Instead, it caused more severe, painful lesions. The patient died 3 months later.

This case highlights that Calciphylaxis is associated with a high mortality rate and better effective management is needed for the survival of the patients.

Reference: Journal of Medical Case Reports



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