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논문분류	춘계학술대회 초록집
제목	Recurrence of Calcinosis Cutis in a Female Post Near-Total Parathyroidectomy and Kidney Transplant: A Case Report
저자	Marvin Ace Tindoy
출판정보	2024; 2024(1):
키워드
초록	Calcinosis cutis is a rare disorder characterized by accumulation of calcium salt crystals into cutaneous and subcutaneous tissues. We report a case of recurrence of calcinosis cutis in a 41 year old female, previously on hemodialysis secondary to lupus nephritis since 2016, who had her kidney transplant last 2023. She had history of near-total parathyroidectomy secondary to tertiary hyperparathyroidism with metastatic calcinosis last 2019. Routine blood tests with additional tests on uric acid, intact PTH, vitamin D assay, and calcium were tested which showed all normal. Among the subtypes, dystrophic or metastatic subtypes of calcinosis cutis were considered. Dystrophic calcification is a localized tissue damage with normal serum calcium and phosphate levels while metastatic calcification is an abnormal calcium and/or phosphate metabolism, leading to the precipitation of calcium in cutaneous and subcutaneous tissue. Diagnosis of calcinosis cutis was evident based on the extrusion of chalky white material from the lesion. A X-ray and biopsy is usually used to confirm this diagnosis. Given the patient’s history of kidney disease, near-total parathyroidectomy due hyperparathyroidism and kidney transplantation, diagnosis of metastatic calcinosis cutis was considered but was ruled out due to normal calcium/phosphate levels with localized tissue damage. Hence, the diagnosis of dystrophic calcinosis cutis was highly considered. This recurrence of calcinosis cutis at the 4th digit of right hand only probably was a remnant of previous history of tertiary hyperparathyroidism despite parathyroidectomy and kidney transplantation or probably associated from her history of lupus nephritis which is said to be very rare although its pathogenic mechanism are still not completely elucidated. There has been no standard algorithms or guidelines in treating calcinosis cutis. Surgical approach through excision can be effective in managing small, localized and painful lesions. In this patient, medical management through adequate and proper wound care was done to avoid infection.
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