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Penile calciphylaxis: A retrospective case-control study - 12/10/21

Doi : 10.1016/j.jaad.2020.05.042 
Colleen Gabel, BS a, Teja Chakrala, BS b, Radhika Shah, MD, PharmD c, Melissa J. Danesh, MD d, Allison S. Dobry, MD e, Anna Cristina Garza-Mayers, MD, PhD d, Lauren N. Ko, MD, MEd d, Emily Nguyen, BS a, Jessica St. John, MD, MBA, MPH f, Andrew C. Walls, MD g, Sagar U. Nigwekar, MD, MMSc h, Philip I. Song, MD i, Daniela Kroshinsky, MD, MPH a,
a Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts 
b Narayana Medical College and Hospital, Nellore, India 
c Department of Dermatology, Robert Wood Johnson Medical School, New Brunswick 
d Department of Dermatology, Harvard Medical School, Boston, Massachusetts 
e Department of Dermatology, University of California, Irvine School of Medicine, Irvine, California 
f Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts 
g Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts 
h Department of Nephrology, Massachusetts General Hospital, Boston, Massachusetts 
i Department of Dermatology, Palo Alto Medical Foundation, Palo Alto, California 

Correspondence to: Correspondence and reprint requests to: Daniela Kroshinsky, MD, MPH, Department of Dermatology, Massachusetts General Hospital, 50 Staniford St, 2nd Floor, Boston, MA 02114.Department of DermatologyMassachusetts General Hospital50 Staniford St2nd FloorBostonMA02114

Abstract

Background

Calciphylaxis is a rare disorder characterized by skin necrosis caused by calcium deposition within vessels, thrombosis, and subsequent tissue ischemia. Penile involvement may rarely occur.

Objective

To identify risk factors, diagnosis, management, and mortality of patients with penile calciphylaxis.

Methods

A retrospective medical record review was conducted of 16 patients with penile calciphylaxis treated at 2 large urban tertiary care centers between January 2001 and December 2019. A control group of 44 male patients with nonpenile calciphylaxis at the same institution was included.

Results

The median survival of patients with penile calciphylaxis was 3.8 months (interquartile range, 27.0 months). Mortality was 50% at 3 months and 62.5% at 6 months for penile calciphylaxis, and 13.6% at 3 months and 29.5% at 6 months for controls (P = .008). Patients with penile calciphylaxis were less likely to be obese (P = .04) but more likely to have hyperparathyroidism (P = .0003) and end-stage renal disease (P = .049).

Limitations

Retrospective study design and small sample size.

Conclusions

This study further defines the disease course of penile calciphylaxis, which has high mortality. Imaging may be used to aid diagnosis. Risk factors include end-stage renal disease, hyperparathyroidism, and normal body mass index.

Il testo completo di questo articolo è disponibile in PDF.

Key words : calciphylaxis, diagnosis, management, outcomes, penile, risk factors

Abbreviations used : ESRD, STS


Mappa


 Funding sources: None.
 Conflicts of interest: Dr Nigwekar has received grant support from Hope Pharmaceuticals. Authors Gabel, Chakrala, and Nguyen and Drs Shah, Danesh, Dobry, Garza-Mayers, Ko, St. John, Walls, Song, and Kroshinsky have no conflicts of interest to declare.
 IRB approval status: Reviewed and approved by Partners Institutional Review Board: 2018P000551


© 2020  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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