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Abstract: PO0396

Penile Calciphylaxis: Challenges in Its Diagnosis and Management

Session Information

Category: Trainee Case Report

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Tomacruz, Isabelle Dominique Villegas, Philippine General Hospital, Manila, Metro Manila, Philippines
  • Arenos, Carl, Philippine General Hospital, Manila, Metro Manila, Philippines
  • Estreller, Sachiko S., Philippine General Hospital, Manila, Metro Manila, Philippines
  • Ke, Blythe N., Philippine General Hospital, Manila, Metro Manila, Philippines
  • Abalos-Babaran, Shahara, Philippine General Hospital, Manila, Metro Manila, Philippines
  • Montemayor, Elizabeth, Philippine General Hospital, Manila, Metro Manila, Philippines
Introduction

Penile calciphylaxis is an uncommon presentation of a rare systemic disorder.

Case Description

We discuss 2 cases of penile calciphylaxis in patients with end stage kidney disease on hemodialysis presenting with painful ulcerations and eschar formation on their penile shaft. Diabetes mellitus, hyperphosphatemia and vascular calcifications on radiographs were common in both patients. A multidisciplinary approach to management involved wound care with irrigation followed by application of petrolatum-impregnated wet-to-dry dressing, antibiotic therapy, intensification of hemodialysis and use of intravenous sodium thiosulfate. Both patients showed good wound healing on discharge.

Discussion

Skin biopsy may aid in confirmation, but should be weighed against the risks of provoking nonhealing wounds & secondary infection. A high index of suspiscion and multidisciplinary management are key components; but, prognosis is poor with survival rates reported to be less than a year upon diagnosis.

Case 1.Penile ulcer

Case 2. A&B.Penile and lower extremity lesions. C.Vascular calcifications on radiograph. D.Punch biopsy of the leg ulcer consistent with calciphylaxis(H&E stain,40x). E.Thready calcium deposits in the lobular panniculus together with calcification of a medium-sized vessel(H&E stain,10x)