Calcinose distrófica cutânea na doença venosa crônica de membros inferiores
Dystrophic calcinosis cutis in chronic venous disease of the lower limbs
Carolina Heil Arostegui Pacheco; Carmen Lucia Lascasas Porto; Juliana de Miranda Vieira; Ana Leticia de Mattos Milhomens; Rossano Kepler Alvim Fiorelli; Stenio Karlos Alvim Fiorell; Marcos Arêas Marques
Resumo
As úlceras de membros inferiores, secundárias à doença venosa crônica (DVC), constituem um problema significativo de saúde pública no Brasil e representam cerca de 70% do total dessas úlceras. Apesar dos recentes avanços tecnológicos e das diversas opções terapêuticas utilizadas para essas lesões crônicas, existem diversos fatores que podem estar implicados na resistência ao tratamento. A calcificação distrófica cutânea (CDC) é uma condição rara e frequentemente subdiagnosticada, que, quando associada à DVC, pode estar associada à refratariedade no processo cicatricial. Neste artigo, relatamos um caso de CDC em paciente portador de DVC e discutimos a sua etiologia, fisiopatologia e possíveis opções de tratamento.
Palavras-chave
Abstract
Lower limb ulcers secondary to chronic venous disease (CVD) are a significant public health problem in Brazil and
account for about 70% of these ulcers. Despite recent technological advances and the various therapeutic options for
treatment of these chronic injuries, several factors may be involved in resistance to treatment. Dystrophic calcinosis
cutis (DCC) is a rare and often underdiagnosed condition that, when in conjunction with CVD, may be associated
with a refractory healing process. In this article, we report a case of DCC in a patient with CVD and discuss its etiology,
pathophysiology and possible treatment options.
Keywords
References
1 Reiter N, El-Shabrawi L, Leinweber B, Berghold A, Aberer E. Calcinosis cutis. Part I: diagnostic pathway. J Am Acad Dermatol. 2011;65(1):1-12.
2 Jiménez-Gallo D, Ossorio-García L, Linares-Barrios M. Calcinosis cutis and calciphylaxis. Actas Dermosifiliogr. 2015;106(10):785-94.
3 Tawekji T, Abdul-Baki MN, Dhemesh Y, Douri T. Diffuse idiopathic calcinosis cutis: a case report in a 13-year-old Syrian boy. Oxf Med Case Reports. 2020;2020(7):a054.
4 Tokoro S, Satoh T, Okubo Y, Igawa K, Yokozeki H. Latent dystrophic subcutaneous calcification in patients with chronic venous insufficiency. Acta Derm Venereol. 2009;89(5):505-8.
5 Enoch S, Kupitz S, Miller DR, Harding KG. Dystrophic calcification as a cause for non-healing leg ulcers. Int Wound J. 2005;2(2):142-7.
6 Walsh JS, Fairley JA. Calcifying disorders of the skin. J Am Acad Dermatol. 1995;33(5 Pt 1):693-706.
7 Alsaif F, Abduljabbar AM. Unilateral idiopathic calcinosis cutis: a case report. Case Rep Dermatol. 2017;9(1):20-4.
8 Boulman N, Slobodin G, Rozenbaum M, Rosner I. Calcinosis in rheumatic diseases. Semin Arthritis Rheum. 2005;34(6):805-12.
9 Kim MS, Choi KC, Kim HS, Song IG, Shin BS. Calcinosis cutis in systemic lupus erythematosus: a case report and review of the published work. J Dermatol. 2010;37(9):815-8.
10 Wollina U, Hasenöhrl K, Köstler E, et al. Dystrophic calcification in chronic leg ulcers: a clinicopathologic study. Dermatol Surg. 2009;35(3):457-61.
11 Lippmann HI, Goldin RR. Subcutaneous ossification of the legs in chronic venous insufficiency. Radiology. 1960;74(2):279-88.
12 Piry A, Vin F, Allaert FA. Inflammation and subcutaneous calcification of venous origins. Phlebologie. 1992;45(1):41-7, discussion 48-9. PMid:1496031.
13 Lindner B. Disseminated cutaneous calcination of lower leg. Arch Dermatol Syph. 1953;196(4):403-12.
14 Reiter N, El-Shabrawi L, Leinweber B, Berghold A, Aberer E. Calcinosis cutis: Part II. Treatment options. J Am Acad Dermatol. 2011;65(1):15-22.
15 Kutlubay Z, Yardimci G, Gokler G, Engin B. A dystrophic calcinosis cutis case treated with CO2 laser. J Cosmet Laser Ther. 2014;16(3):144-6.
16 Delgado-Márquez AM, Carmona M, Vanaclocha F, Postigo C. Effectiveness of extracorporeal shock wave lithotripsy to treat dystrophic calcinosis cutis ulcers. Actas Dermosifiliogr. 2015;106(2):140-3. PMid:25441166.
17 Callam MJ, Ruckley CV, Harper DR, Dale JJ. Chronic ulceration of the leg: extent of the problem and provision of care. Br Med J (Clin Res Ed). 1985;290(6485):1855-6.
18 Castelo Branco S, Costa M, Vasconcelos A. Chronic venous insufficiency and dystrophic subcutaneous calcification. Acta Med Port. 2019;32(2):165.
Submitted date:
12/30/2021
Accepted date:
06/13/2022