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Topography and aspect of Calciphylaxis lesions of patient 1.
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After three years of thrice-weekly hemodialysis treatment (with a single-pool Kt / V at 1.27 and dialysate Ca at 1.5 mmol/L), our patient presented with necrotic and painful extremities skin lesions (Figure 1).
Evolution of Calciphylaxis lesions over 4 months of treatment in patient 1. Necrosectomy could not be performed at the heels because of the risk of injury to the Achilles tendon.
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Local care was performed daily until complete healing of the lesions (Figure 2).
PMC6601500_02
Calciphylaxis lesions at the admission of patient 2 (A: right leg, B: left leg).
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The patient was consulted for erythematous, necrotic, and painful skin lesions of her right leg (Figure 3.1). The lesions worsened and spread to the contralateral leg within 5 days (Figure 3.2).
(1) A skin biopsy and adipose tissue in patient 2 with foci of necrosis, calcification of arteriolar walls, and necrotizing panniculitis in the context of a uremic calcifying arteriopathy. (2) Intimal thickening and fibrin thrombi in patient 2 skin biopsy.
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A concomitant biopsy of skin lesions confirmed the already mentioned diagnosis of calciphylaxis (Figure 4).
Evolution of Calciphylaxis lesions over 3 months of treatment in patient 2.
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Fortunately, the complete healing of the lesions was obtained by 4 months (Figure 5).