PMC7243381_01
(a) The blistering of the abdominal wall. (b) Ulceration with purulence on the abdominal wall. (c) Completely healed ulcer on the abdominal wall at 4 months with treatment.
10.1177_2324709620922718-fig1.jpg
PMC7243381_01_10.1177_2324709620922718-fig1.jpg
fig1-2324709620922718
A 51-year-old female with the history of ESRD on home hemodialysis, antiphospholipid syndrome on warfarin, systemic lupus erythematosus, diabetes mellitus, hyperparathyroidism, and bowel obstruction followed by the surgical repair in the past admitted to the hospital with severe pain and hardness in the abdominal wall as shown in Figure 1a. Even with warfarin on hold, the lesions increased in size, became more painful, and started to ulcerate as showed in Figure 1b. Figure 1b. Firm subcutaneous lumps were felt bilaterally on the lower abdomen, which are tender to palpation. The course of wound healing was described in images with timeline (Figure 1a, b, and c). The ulcers completely resolved in 4 months (Figure 1c), wound care was discontinued, sodium thiosulfate infusions were stopped, and the patient's home dialysis frequency was decreased to 5 times a week.