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The following is a summary of “Histologic comparison of normal and diseased skin in patients with suspected calciphylaxis,” published in the May 2025 issue of Journal of the American Academy of Dermatology by Cheeley et al. 

Researchers conducted a retrospective study to compare histology between diseased and normal skin in patients with suspected calciphylaxis.  

They examined biopsies from 18 patients with suspected calciphylaxis for vascular calcification, thrombosis, intimal hyperplasia, and extravascular calcification.  

The results showed that all but 2 patients were on dialysis, half had diabetes, and half used warfarin, with nearly all exhibiting thigh involvement. Small artery or arteriole calcification appeared in 56% of lesional samples (11) and 44% of controls (8), with 4 patients showing calcification in both. Coarse calcification was found in 6 lesional samples but none in controls (P=0.02). Thrombosis (50%, P=0.001) and intimal hyperplasia (39%, P=0.008) occurred exclusively in lesional tissue. Among 9 samples with thrombosis, 8 had vascular calcification. Intimal hyperplasia coincided with vascular calcification in 6 of 7 samples and thrombosis in 6 of 7. Extravascular calcification was present in both lesional and control tissues.  

Investigators concluded that vascular calcification alone lacked specificity, while thrombosis and intimal hyperplasia combined with severe vascular calcification were specific findings indicating a pathogenic role. 

Source: jaad.org/article/S0190-9622(25)02187-5/abstract