%0 Journal Article
%T Clinical mimickers of calciphylaxis: A retrospective study.
%A Gabel CK
%A Blum AE
%A François J
%A Chakrala T
%A Dobry AS
%A Garza-Mayers AC
%A Ko LN
%A Nguyen ED
%A Shah R
%A John JS
%A Nigwekar SU
%A Kroshinsky D
%J J Am Acad Dermatol
%V 85
%N 6
%D Dec 2021
%M 33744358
%F 15.487
%R 10.1016/j.jaad.2021.03.035
%X <B>BACKGROUND: </B>Calciphylaxis is an ischemic vasculopathy with high morbidity and mortality. Early and accurate diagnosis is critical to management of calciphylaxis. Clinical mimickers may contribute to delayed or misdiagnosis.<BR><B>OBJECTIVE: </B>To assess the rate and risk factors for misdiagnosis and to identify clinical mimickers of calciphylaxis.<BR><B>METHODS: </B>A retrospective medical record review was conducted of patients with calciphylaxis at a large urban tertiary care hospital between 2006 and 2018.<BR><B>RESULTS: </B>Of 119 patients diagnosed with calciphylaxis, 73.1% were initially misdiagnosed. Of patients not initially misdiagnosed, median time to diagnosis from initial presentation was 4.5 days (interquartile range, 1.0-23.3), compared to 33 days (interquartile range, 13.0-68.8) in patients who were initially misdiagnosed (P = .0002). The most common misdiagnoses were cellulitis (31.0%), unspecified skin infection (8.0%), and peripheral vascular disease (6.9%). Patients who were misdiagnosed frequently received at least 1 course of antibiotics. Patients with end-stage renal disease were less likely to be misdiagnosed than those without this disease (P = .001).<BR><B>CONCLUSIONS: </B>Single-center, retrospective study.<BR><B>CONCLUSIONS: </B>Understanding the risk factors for misdiagnosis of calciphylaxis is an opportunity for further education concerning this rare disease.