Venous Stasis Ulcer Complicated by Calcinosis Cutis
Venous Stasis Ulcer Complicated by Calcinosis Cutis
A 61-year-old Native American woman presented with a painful, full-thickness, infected, mixed fibrin and eschar, venous stasis ulcer of the left lower lateral leg approximately six weeks in duration (Figure 1). Symptoms began after she collided with a wooden bench. In an attempt to treat her wound, she preformed self care that included daily soap and water cleansing, wet-to-dry dressings, and compressive therapy. The wound progressively enlarged becoming more painful and unresponsive to self care. During deep debridement, two flat irregularly shaped foreign bodies were discovered and removed from the subcutaneous tissue. Specimens were sent to pathology for gross and microscopic examination (Figure 2).
(Enlarge Image)
Circular full-thickness wound measuring 2.9cm x 3.5cm x 0.3cm of left lower lateral leg as initial wound presentation.
(Enlarge Image)
Aberrant calcium deposits removed from subcutaneous tissue.
The patient's medical history consisted of obesity, hypertension, type II diabetes mellitus, diabetic neuropathy, and chronic renal failure with hemodialysis three times a week. Her surgical history included forearm shunt placement for dialysis and bilateral forefoot pan-transmetatarsal amputations. She had no known drug allergies. Her medications included human insulin twice a day, nifedipine daily, calcium carbonate, sodium bicarbonate, and a multivitamin supplementation daily.
A 61-year-old Native American woman presented with a painful, full-thickness, infected, mixed fibrin and eschar, venous stasis ulcer of the left lower lateral leg approximately six weeks in duration (Figure 1). Symptoms began after she collided with a wooden bench. In an attempt to treat her wound, she preformed self care that included daily soap and water cleansing, wet-to-dry dressings, and compressive therapy. The wound progressively enlarged becoming more painful and unresponsive to self care. During deep debridement, two flat irregularly shaped foreign bodies were discovered and removed from the subcutaneous tissue. Specimens were sent to pathology for gross and microscopic examination (Figure 2).
(Enlarge Image)
Circular full-thickness wound measuring 2.9cm x 3.5cm x 0.3cm of left lower lateral leg as initial wound presentation.
(Enlarge Image)
Aberrant calcium deposits removed from subcutaneous tissue.
The patient's medical history consisted of obesity, hypertension, type II diabetes mellitus, diabetic neuropathy, and chronic renal failure with hemodialysis three times a week. Her surgical history included forearm shunt placement for dialysis and bilateral forefoot pan-transmetatarsal amputations. She had no known drug allergies. Her medications included human insulin twice a day, nifedipine daily, calcium carbonate, sodium bicarbonate, and a multivitamin supplementation daily.
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