BACKGROUND Calciphylaxis is a form of vascular calcification more commonly associated with renal disease. While the exact mechanism of calciphylaxis is poorly understood,most cases are due to end stage kidney disease....BACKGROUND Calciphylaxis is a form of vascular calcification more commonly associated with renal disease. While the exact mechanism of calciphylaxis is poorly understood,most cases are due to end stage kidney disease. However, it can also be found in patients without kidney disease and in such cases is termed non-uremic calciphylaxis for which have multiple proposed etiologies.CASE SUMMARY We describe a case of a thirty-year-old morbidly obese Caucasian female who had a positive history of alcoholic hepatitis and presented with painful calciphylaxis wounds of the abdomen, hips, and thighs. The hypercoagulability panel showed low levels of Protein C and normal Protein S, low Antithrombin Ⅲ and positive lupus anticoagulant and negative anticardiolipin. Wound biopsy confirmed the diagnosis of non-uremic calciphylaxis in the setting of alcoholic liver disease. The calciphylaxis wounds did not improve when Sodium Thiosulfate was used alone. The patient underwent a series of bedside and surgical debridement. Broad spectrum antibiotics were also used for secondary wound bacterial infections. The patient passed away shortly after due to sepsis and multiorgan failure.CONCLUSION Non-uremic Calciphylaxis can occur in the setting of alcoholic liver disease. The treatment of choice is still unknown.展开更多
Background: There has been a longstanding debate regarding whether keratoacanthomas (KAs) are neoplastic or reactive/inflammatory lesions. Aim: The aim of this case report is to, within the aforementioned debate, offe...Background: There has been a longstanding debate regarding whether keratoacanthomas (KAs) are neoplastic or reactive/inflammatory lesions. Aim: The aim of this case report is to, within the aforementioned debate, offer support in favor of the potential reactive nature of keratoacanthomas. Case Presentation: A 64-year-old male presented with an eruption of 25 keratoacanthomas within a red ink tattoo. Eruptions were partially resolved over a matter of months, and completely resolved with treatment using oral Acitretin therapy. We believe this to be the third such reported case of eruptive KAs within only the red ink portions of a tattoo. Prior cases involved 2 and 8 KAs each. Discussion: Multiple studies suggest that KAs are neoplastic in nature and very distinct from cutaneous squamous cell carcinoma. Especially interesting is the finding that KAs have increased expression of apoptotic genes;this is particularly notable because of the tendency for these lesions to spontaneously involute. Skin tumorigenesis can occur in predisposed individuals after carcinogen exposure, thus red ink possesses theoretical potential as a carcinogen. KAs could be seen in this case as in fact a reactive neoplasm.展开更多
文摘BACKGROUND Calciphylaxis is a form of vascular calcification more commonly associated with renal disease. While the exact mechanism of calciphylaxis is poorly understood,most cases are due to end stage kidney disease. However, it can also be found in patients without kidney disease and in such cases is termed non-uremic calciphylaxis for which have multiple proposed etiologies.CASE SUMMARY We describe a case of a thirty-year-old morbidly obese Caucasian female who had a positive history of alcoholic hepatitis and presented with painful calciphylaxis wounds of the abdomen, hips, and thighs. The hypercoagulability panel showed low levels of Protein C and normal Protein S, low Antithrombin Ⅲ and positive lupus anticoagulant and negative anticardiolipin. Wound biopsy confirmed the diagnosis of non-uremic calciphylaxis in the setting of alcoholic liver disease. The calciphylaxis wounds did not improve when Sodium Thiosulfate was used alone. The patient underwent a series of bedside and surgical debridement. Broad spectrum antibiotics were also used for secondary wound bacterial infections. The patient passed away shortly after due to sepsis and multiorgan failure.CONCLUSION Non-uremic Calciphylaxis can occur in the setting of alcoholic liver disease. The treatment of choice is still unknown.
文摘Background: There has been a longstanding debate regarding whether keratoacanthomas (KAs) are neoplastic or reactive/inflammatory lesions. Aim: The aim of this case report is to, within the aforementioned debate, offer support in favor of the potential reactive nature of keratoacanthomas. Case Presentation: A 64-year-old male presented with an eruption of 25 keratoacanthomas within a red ink tattoo. Eruptions were partially resolved over a matter of months, and completely resolved with treatment using oral Acitretin therapy. We believe this to be the third such reported case of eruptive KAs within only the red ink portions of a tattoo. Prior cases involved 2 and 8 KAs each. Discussion: Multiple studies suggest that KAs are neoplastic in nature and very distinct from cutaneous squamous cell carcinoma. Especially interesting is the finding that KAs have increased expression of apoptotic genes;this is particularly notable because of the tendency for these lesions to spontaneously involute. Skin tumorigenesis can occur in predisposed individuals after carcinogen exposure, thus red ink possesses theoretical potential as a carcinogen. KAs could be seen in this case as in fact a reactive neoplasm.
