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Dystrophic calcification in leg ulcers
Amina Khalid, Alyson Bryden
An 84 year old woman with bilateral chronic leg ulcers had numerous dark brown, bony, hard calcified deposits within the ulcer base and subcutaneous tissue (arrows). Lower limb radiography showed extensive reticular calcification. Serum calcium and phosphate were normal. Dystrophic calcification is a recognised complication of chronic venous hypertension. True prevalence is difficult to evaluate, but it is reported to be 10-40%. It is an overlooked cause of painful non-healing ulcers, resistant to conservative treatment. Radiography is helpful if this diagnosis is suspected. Surgical excision with mesh grafting has been used in specialist centres with varying success.