CALCIFYING PANNICULITIS - MANAGEMENT WITH CIMETIDINE
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AN interesting case report appeared in Dermatology 1996:192:156-59 by EM
Elamin and AB McDonald titled "Calcifying Panniculitis with Renal
Failure: A New Management Approach"
 
The authors treated a 60 yo woman with renal failure, hyperphosphatemia,
normocalcemia, amd hyperparathyroidism who had skin and subcutaneous
tissue necrosis of the thighs with prednisone 40mg daily X 10 days
followed by oral cimetidine 300mg BID. The cutaneous ulcers healed in
three months and no recurrence has occurred in 9 mos.
        What's new here is the use of cimetidine. The rational is
unclear. The authors used it because of its beneficial effect in
disorders "classified under the term fasciitis-panniculitis syndrome and
usually presenting as subcutaneous induration due to cicatrizing
fasciitis plus septal and lobular panniculitis and perimysial fibrosis."
(I can barely keep up with all the patients in my waiting room with
perimysial fibrosis)
I'm wondering if the patient with the penile ulcer discussed with
this group has the criteria discussed by Selye for calciphylaxis, and
whether cimetidine long term might help. 

Haines Ely, MD.
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