Abstract

A female dialysis patient with a consistently high serum calcium phosphate product presented with large necrotic skin lesions with ulcers. The clinical course was highly suggestive of calciphylaxis. Parathyroidectomy was followed by the healing of the lesions. New skin lesions appeared following relapse of hyperparathyroidism. Her clinical records included a long past of hypertension, which was the cause of her renal failure. She had a limited walking range and previously had presented bilateral ulcers of vascular origin. This case presents a type of lesion which bears a serious prognosis in dialysis patients. The clinical context and the presentation of the lesions are compatible with multiple etiology: vascular lesions and calciphylaxis. The documented longitudinal follow-up illustrates the importance of treating the different factors known to participate in the appearance of skin lesions in dialysis patients. Particularly, it stresses the benefit of performing parathyroidectomy, even if the parathyroid hormone level is not in the range normally accepted as requiring surgical removal of parathyroid glands.

Author Details

Authors

• V. Garrigue¹
• R. Lorho²
• S. Canet¹
• D. Augias³
• M.-F. Servel⁴
• B. Canaud¹
• B. Albat⁵
• G. Mourad¹
• A. Argilés¹,²

Departments

• ¹ Department of Nephrology, University Hospital Lapeyronie,
• ² Institut de Génétique Humaine – CNRS UPR
• ¹ 
• ¹ 
• ⁴ 
• ² ,
• ³ Department of Dermatology, University Hospital St Eloi,
• ⁴ Association pour l’Installation à Domicile des Epurations Rénales (AIDER), and
• ⁵ Department of Cardiovascular Surgery, University Hospital Arnaud de Villeneuve, Montpellier Cedex
• ⁵ , France

Address

Citation