Authors: Corazon Almira T. Mella; Ma. Lourdes Aragon De Veyra
Introduction/background: Calcific uremic arteriolopathy commonly known as calciphylaxis is a rare, life-threatening, vasculopathy affecting approximately 4% of patients with end stage renal disease. Involvement of the penis is considered an unusual phenomenon indicating a higher rate mortality at 69% within 6 months. Management of the condition remains controversial. Here, we report a case of a 40-year-old male, diagnosed with end-stage renal disease since 2016, who presented with firm, necrotic, plaques on his glans penis.
Objectives: To describe a case of penile calciphylaxis managed conservatively.
Case Summary: A 40-year-old male with end-stage renal disease, presented with a history of erythematous based erosions on his glans penis which rapidly progressed to eschar formation in a span of one week. Necrotic plaques involving the fingers, increased levels of parathyroid hormone and calcium phosphorus product, further supported the diagnosis of calciphylaxis. Conservative management of the condition was done including intravenous infusion and topical application of Sodium thiosulfate, hyperbaric oxygen therapy, chlorhexidine wash and intake of Sildenafil. Compliance to treatment was excellent and proved to be beneficial as decrease in the diameter of necrotic plaques and cessation of progression of the condition were noted.
Conclusion: Calcific uremic arteriolopathy is a rare condition requiring immediate intervention. In the advent of increasing number of hemodialysis patients, clinicians should carry a high-index of suspicion to diagnose the condition to avoid further complications. Choosing to approach the disease aggressively or conservatively is still a debate and thus, recognition of the disease and further studies on management should be advocated.
Calciphylaxis, penile, conservative
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