Title : A case of calciphylaxis of the breast in a 74-year-old woman
Abstract:
Introduction: Calciphylaxis is a disease in which metastatic calcification affects small and medium-ships, resulting in significant dermatological manifestations. The lesions typically occur in areas of high fat content and gradually progress to pressure sores. We report a case of calciphylaxis, particularly in the areolar region, treated at the Algiers Hospital.
Case Report: A 74-year-old patient with end-stage renal failure (ESRF) on dialysis presented with painful skin necrosis of the right breast that had been progressing for 1 month. Examination revealed an ulcer covered by a blackish crust in the areolar region. Laboratory findings revealed end-stage renal failure due to diabetic nephropathy, with normal calcium and phosphate levels. Histology revealed an infiltrate rich in neutrophils, calcifications of the connective tissue, and calcifications of the arteriole wall with an organized thrombus. Treatment included necrectomy and a modification of dialysis with a low-calcium bath.
Discussion: In our patient, the renal failure context, the significant pain, and the hard necrotic plaque surrounded by a livedoid halo are highly suggestive of calcific arteriopathy. This is a rare case of calciphylaxis. Deep skin biopsy confirmed the diagnosis.This is a rare case of calciphylaxis. A deep skin biopsy confirmed the diagnosis. Breast involvement is very rare. Current management of patients with calciphylaxis with sodium thiosulfate infusion appears to improve the prognosis.
Conclusion: Calciphylaxis is a rare but extremely serious complication of end-stage renal disease requiring long-term dialysis. Early diagnosis allows for rapid and appropriate management.
Keywords: calcinosis cutis, calciphylaxis, chronic renal failure
