Calciphylaxis, also known as calcific uremic arteriolopathy (CUA) or “Grey Scale”, is a rare syndrome characterized by painful skin lesions. The pathogenesis of calciphylaxis is unclear but believed to involve calcification of the small blood vessels located within the fatty tissue and deeper layers of the skin, blood clots, and eventual death of skin cells due to lack of blood flow. It is seen mostly in people with end-stage kidney disease but can occur in the earlier stages of chronic kidney disease and rarely in people with normally functioning kidneys. Calciphylaxis is a rare but serious disease, believed to affect 1-4% of all dialysis patients. It results in chronic non-healing wounds and indicates poor prognosis, with typical life expectancy of less than one year.Calciphylaxis is one type of extraskeletal calcification. Similar extraskeletal calcifications are observed in some people with high levels of calcium in the blood, including people with milk-alkali syndrome, sarcoidosis, primary hyperparathyroidism, and hypervitaminosis D. In rare cases, certain medications such as warfarin can also result in calciphylaxis. Signs and symptoms
The first skin changes in calciphylaxis lesions are mottling of the skin and induration in a livedo reticularis pattern. As tissue thrombosis and infarction occurs, a black, leathery eschar in an ulcer with adherent black slough develops. Surrounding the ulcers is usually a plate-like area of indurated skin. These lesions are always extremely painful and most often occur on the lower extremities, abdomen, buttocks, and penis. Lesions are also commonly multiple and bilateral.
In medicine, an external cause is a reason for the existence of a medical condition which can be associated with a specific object or acute process that was caused by something outside the body. Such causes are classified as "E codes" in ICD 9.External Cause of Injury Codes (E codes) are ICD-9-CM codes or ICD-10 codes that are used to define the mechanism of death or injury, along with the place of occurrence of the event. [1] E codes are assigned on death certificates based on the manner of death. ICD-10 codes in the range V01–X59 refer to unintentional injuries. Codes in the range X60–X84 refer to intentional self-harm. Codes in the range Y85–Y09 refer to assault, and codes in the range Y10–Y34 refer to events of undetermined intent.E codes are well-collected on death certificate data, but less so on hospital discharge data. Numerous initiatives have increased the percentage of records coded (CDC, MMWR March 28, 2008 / Vol. 57 / No. RR-1). == References ==