title: Painful ulcers in calciphylaxis - combined treatment with maggot therapy and oral pentoxyfillin.
abstract: BACKGROUND
  Calciphylaxis is a rare syndrome developing predominantly in female patients suffering from end-stage renal disease (ESRD) with secondary hyperparathyroidism. Skin lesions begin as superficial patches that quickly progress to painful necrotic ulcers. Histopathological findings are calcification of small arteries and arterioles and infarction of subcutis and skin. The prognosis of calciphylaxis is poor due to an increased risk of systemic infection.
  
  
  METHODS
  We report on a 50-year-old woman suffering from calciphylaxis. Initial treatments were not tolerated due to pain and therefore the patient was treated with maggot therapy and 800 mg/day of oral pentoxyfillin.
  
  
  RESULTS
  Over a period of 6 months a complete remission of her skin lesions was achieved.
  
  
  CONCLUSIONS
  Patients suffering from ulcers due to calciphylaxis may benefit from the use of maggot therapy, which cleanses ulcers and prevents systemic infection.
authors.affiliation: Department of Dermatology, Friedrich-Schiller University of Jena, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Tittelbach
authors.forename: T
authors.initials: T
authors.lastname: Graefe
authors.forename: U
authors.initials: U
authors.lastname: Wollina
mesh_terms: D000284:Administration, Oral; D000818:Animals; D002115:Calciphylaxis / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007814:Larva; D007871:Leg Ulcer / Q000628:therapy*; D008875:Middle Aged; D010431:Pentoxifylline / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D010431:Pentoxifylline