Study led by McMullen and Chan published in the American Journal of Surgical Pathology

By Elizabeth Walker | September 6 2019

When vascular calcification is identified on von Kossa only, presence of microthrombi in the subcutaneous fat is required to favor a diagnosis of calciphylaxis in the appropriate clinical context. A study by Drs. Emily McMullen, Paul Harms, Lori Lowe, Doug Fullen, and May Chan is published in the September issue of the American Journal of Surgical Pathology (AJSP). Calciphylaxis is a dermatologic emergency where an accurate and timely diagnosis is crucial but often challenging. The team examined a cohort of calciphylaxis, gangrene, amputation margin, chronic stasis, and thrombotic vasculopathy for the presence and distribution of calcium deposits, in addition to various clinical and histopathologic features. They found that fine calcium deposition in vessel walls alone, when identified on von Kossa stain only, has limited specificity. An algorithm incorporating anatomic location and both vascular calcification and microthrombi in the subcutaneous fat was proposed to help improve diagnostic accuracy for calciphylaxis. A link to the article can be found at ovid.com.