Török L, Középessy L
Department of Dermatology, County Hospital Bács-Kiskun, Kecskemét, Hungary.
Clin Exp Dermatol. 1996 Jan;21(1):75-7. doi: 10.1046/j.1365-2230.1996.d01-175.x.
Cutaneous and subcutaneous gangrene are serious sequelae of secondary or tertiary hyperparathyroidism which may accompany chronic renal failure. Based on analysis of the present typical case and a retrospective survey of similar cases in the literature, we propose the term 'uraemic gangrene syndrome' for this association. These skin lesions in chronic renal failure patients represent the most serious clinical manifestation of calciphylaxis, a condition originally described by Selye. The appearance of early skin lesions should be regarded as an indication for subtotal parathyroidectomy. The association of cutaneous gangrene with vascular calcification was first described by Bryandt and White in 1989, and was termed by these authors as 'gangrenous calcification'. A total of 80 cases of this rare complication of chronic renal disease had been reported up to early 1994. A retrospective review of these reports has strongly suggested a close interrelationship between renal failure, secondary hyperparathyroidism, vascular calcification and cutaneous gangrene. The present report concerns a characteristic case to draw attention to this syndrome which is accompanied by serious, predominantly cutaneous, changes.
皮肤和皮下坏疽是继发性或三发性甲状旁腺功能亢进的严重后遗症，可能伴有慢性肾衰竭。基于对当前典型病例的分析以及对文献中类似病例的回顾性调查，我们为此关联提出“尿毒症坏疽综合征”这一术语。慢性肾衰竭患者的这些皮肤病变代表了钙质沉着症最严重的临床表现，钙质沉着症最初由塞利描述。早期皮肤病变的出现应被视为甲状旁腺次全切除术的指征。皮肤坏疽与血管钙化的关联最早由布赖恩特和怀特于1989年描述，这些作者将其称为“坏疽性钙化”。截至1994年初，总共报告了80例这种慢性肾病的罕见并发症。对这些报告的回顾性分析强烈表明肾衰竭、继发性甲状旁腺功能亢进、血管钙化和皮肤坏疽之间存在密切的相互关系。本报告涉及一个典型病例，以引起对这种伴有严重的、主要是皮肤变化的综合征的关注。
