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CUA skin-related calcifications composed of calcium-phosphate apatite, localized circumferentially

In a spectroscopic analysis, researchers found circumferential calcifications, located in the intima and media of skin vessels, were composed of calcium-phosphate apatite in patients with calcific uremic arteriolopathy.

“Calcific uremic arteriolopathy-related skin calcifications were exclusively composed of pure calcium-phosphate apatite, localized circumferentially in small to medium-sized vessels and often associated with interstitial deposits, suggesting its pathogenesis differs from that of arteriolosclerosis,” Hester Colboc, MD, from the Wounds and Healing Service at Sorbonne University, Hospital Rothschild, Paris, and colleagues wrote.

In a retrospective, multicenter cohort study at seven French hospitals, researchers identified 36 patients with calcific uremic arteriolopathy (CUA). Five skin samples from patients with arteriolosclerosis were used for comparison, and five samples from the negative margins of skin-carcinoma resection specimens were assessed.

Optical microscopy and field emission scanning electron microscopy were used to assess the localization and morphologic features of CUA-related cutaneous calcium deposits. Raman spectroscopy, energy dispersive radiographs and micro-Fourier transform infrared spectroscopy were used to evaluate chemical compositions.

There were 29 cutaneous biopsies analyzed. In 22 of the samples, calcific uremic arteriolopathy vascular calcifications were circumferential, found in small to medium-sized vessels with interstitial deposits. There were 12 deaths from CUA reported.

Researchers reported the calcific uremic arteriolopathy and arteriolosclerosis skin calcifications were composed of pure calcium-phosphate apatite.

“A thrombosis, most often in noncalcified capillary lumens in the superficial dermis, was seen in [five] samples from patients with CUA,” the researchers wrote. “Except for calcium deposits, the vessel structure of patients with CUA appeared normal, unlike thickened arteriolosclerotic vessel walls.”– by Monica Jaramillo

Disclosures: Colboc reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.