[Penile calciphylaxis: case report and literature review].
BACKGROUND
Calciphylaxis is a serious condition characterized by ischemic ulceration of the skin and necrosis secondary to dystrophic calcification of the subcutaneous tissue and small arteries. It affects primarily patients with end-stage renal disease with prevalence up to 4%. However, penile calciphylaxis has been reported in only 37 cases in the international literature. We report one case, to review the literature and to provide the basis for a rational treatment of calciphylaxis of the penis that reduces the associated mortality.


METHODS
We report the case of an 82-year-old male with a 15-year history of type 2 diabetes mellitus and renal insufficiency during the past 2 years. He presented an increase of consistency of the distal portion in the penis' glans and scrotal swelling, evolving to complete penile glans necrosis.


CONCLUSIONS
With the increase of the number of patients on dialysis treatment, the prevalence of calciphylaxis will increase. A high index of suspicion is warranted in all patients with end-stage renal disease and who present the characteristic genital lesions. Treatment of this complication must include avoidance of all exogenous calcium, administration of calcitriol analogues to offset the PTH, emergency parathyroidectomy in the case of overt hyperparathyroidism and aggressive surgical treatment with total or partial penectomy.
Soto-Miranda
Miguel Angel
MA
Departamento de Cirugía, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Associación Mexicana de Cirugía General. desw300022@yahoo.com.mx
Goné-Fernández
Alberto
A
Romero-y Huesca
Andrés
A
D000369:Aged, 80 and over; D002115:Calciphylaxis / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003928:Diabetic Nephropathies / Q000150:complications*; D017809:Fatal Outcome; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D008297:Male; D009336:Necrosis; D010409:Penile Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D006435:Renal Dialysis / Q000009:adverse effects