The suspected diagnosis can be supported by a skin biopsy, usually a punch biopsy, which shows arterial calcification and occlusion in the absence of vasculitis. Excisional biopsy should not be done due to increased risk of further ulceration and necrosis. Bone scintigraphy can be performed in cases where skin biopsy is contraindicated. Results of the study show increased tracer accumulation in the soft tissues. In certain patients, an anti-nuclear antibody test may play a role in diagnosis of calciphylaxis. Plain radiography and mammography may also show calcifications but these tests are less sensitive. Laboratory studies, such as phosphate levels, calcium levels, and parathyroid levels, are nonspecific and unhelpful for diagnosis of calciphylaxis. Treatment
The treatment of calciphylaxis requires a multidisciplinary approach, using the knowledge of nephrologists, plastic surgeons, dermatologists, and wound care specialists working together to manage the disease and its outcomes. The key to treating calciphylaxis is prevention via rigorous control of phosphate and calcium balance and management of risk factors in patients who have increased chances of developing calciphylaxis. There is no specific treatment. Most treatment recommendations lack significant data, and none are internationally recognized as the standard of care. It is generally accepted to apply a multi-pronged approach to each patient. Analgesia and wound management
Pain management and choice of analgesia is a challenging task in managing calciphylaxis. Pain is one of the most severe and pervasive symptoms of the disease and can be unresponsive to high-dose opioids.
Lobomycosis is a fungal infection of the skin. It usually presents with bumps in the skin, firm swellings, deep skin lesions, or malignant tumors.It is caused by Lacazia loboi (formerly named Loboa loboi). Transmission is generally by direct contact with contaminated water, soil, vegetation, or by direct contact with an infected dolphin.Diagnosis is by identifying Lacazia laboi in a lesion.This disease is usually found in humans and bottlenose dolphins, with the possible risk of transmission from one species to the other.It was discovered by Brazilian dermatologist Jorge Lobo. Other names which were given to the disease are: keloidal blastomycosis, Amazonian blastomycosis, blastomycoid granuloma, miraip and piraip. These last two names were given by natives of the Amazon and mean that which burns. Signs and symptoms
The disease is endemic in rural regions in South America and Central America.Infection most commonly develops after minor scratches or insect bites, but many patients cannot recall any skin trauma. Human-to-human transmission does not occur, and the disease is only acquired from the environment. The disease manifests as chronic keloidal nodular lesions on the ears, legs, or arms. Diagnosis of Lobos disease is made by taking a sample of the infected skin (a skin biopsy) and examining it under the microscope. Lacazia loboi is characterized by long chains of spherical cells interconnected by tubules. The cells appear to be yeast-like with a diameter of 5 to 12 μm. Attempts to culture L. loboi have so far been unsuccessful.