A case of calciphylaxis associated with multiple skin ulcers on the extremities

Abstract

We reported a 58-year-old woman with chronic renal failure who had been treated by hemodialysis since 1992. Painful skin lesions with black necrosis suddenly developed on her left arm, right femur and right thigh on Jan. 2003. We observed these dark red skin lesions with surrounding necrosis on her first visit to our hospital on 14 May, 2003. The skin biopsy showed degeneration and necrosis in the epidermis, and calcium-phosphate deposition on the arterial vessels in the dermis and subcutaneous fat, and the condition was diagnosed as calciphylaxis. The calcium and parathyroid hormone levels in the serum were normal but there was a high level of phosphate in the serum. The infection of the skin lesions could not be controlled well by antibiotics and skin ulcers enlarged. Sevelamer hydrochloride was effective to stop the progress of the skin lesions. She died suddenly after vomiting with no apparent cause.