Calciphylaxis: Diagnostic and Treatment Advances for the Inpatient Dermatologist

Purpose of Review: Calciphylaxis is a rare, life-threatening condition that frequently requires inpatient dermatology management. This article provides a comprehensive overview of the risk factors, classification, and pathogenesis of calciphylaxis, and summarizes current evidence for diagnostic testing and multi-disciplinary therapeutic management. Recent Findings: The two major subtypes of calciphylaxis tend to present in different anatomic locations, with non-uremic lesions favoring the distal extremities. Skin biopsies obtained on the distal extremities are more sensitive in detecting calciphylaxis-related vascular calcifications, compared to other sites. Underlying hypercoagulable disorders are common among calciphylaxis patients, implicating thrombosis as a major mediator of this disease and highlighting the potential therapeutic role of anticoagulants. Summary: Calciphylaxis is a challenging condition to treat, requiring multi-disciplinary care from dermatology, nephrology, pain medicine, plastic/general surgery, and palliative care. Inpatient dermatologists should be aware of the risk factors associated with calciphylaxis and focus therapy with pharmacologic agents and local wound care.