Colleen Gabel1, Teja Chakrala2, Radhika Shah3, Melissa J Danesh4, Allison S Dobry5, Anna Cristina Garza-Mayers4, Lauren N Ko4, Emily Nguyen1, Jessica St John6, Andrew C Walls7, Sagar U Nigwekar8, Philip I Song9, Daniela Kroshinsky10. 1. Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts. 2. Narayana Medical College and Hospital, Nellore, India. 3. Department of Dermatology, Robert Wood Johnson Medical School, New Brunswick. 4. Department of Dermatology, Harvard Medical School, Boston, Massachusetts. 5. Department of Dermatology, University of California, Irvine School of Medicine, Irvine, California. 6. Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts. 7. Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts. 8. Department of Nephrology, Massachusetts General Hospital, Boston, Massachusetts. 9. Department of Dermatology, Palo Alto Medical Foundation, Palo Alto, California. 10. Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: dkroshinsky@partners.org.
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.
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.