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Discussion

Our patient does have risk factors such as diabetes mellitus, female sex, morbid obesity, and skin trauma from falls which might have increased her risk for developing nonuremic calciphylaxis. Early stages of calciphylaxis are misdiagnosed as cellulitis and usually mistreated with antibiotics. Elevations in serum phosphate or calcium levels are not specific. Skin biopsy is the standard method for confirmation of calciphylaxis, however, its role in clinical practice is debated. The interdisciplinary approach which includes early involvement of dermatology, nephrology, nutrition, pain and palliative medicine, plastic surgery, and wound care with aim of expediting the diagnosis and treatment should be initiated immediately after clinical suspicion. Hypercalcemia and hyperphosphatemia should be corrected. Intake of calcium and Vitamin D should be discontinued. Sodium thiosulfate and Vitamin K supplementation …