# A Peculiar Presentation of a Debilitating Condition: Calciphylaxis

## TL;DR

This paper presents a case of calciphylaxis in a diabetic patient with kidney disease, highlighting its painful symptoms and challenging treatment.

## Contribution

The paper contributes a detailed case report of calciphylaxis with a focus on clinical diagnosis and management challenges.

## Key findings

- Calciphylaxis was diagnosed based on clinical and radiological findings without a skin biopsy.
- The patient experienced intense pain unresponsive to standard analgesics, affecting quality of life.
- Multidisciplinary management is essential for treating calciphylaxis.

## Abstract

Calciphylaxis is a debilitating condition associated with significant morbidity and mortality, often associated with patients with end-stage renal disease, in which the calcification of cutaneous arterioles and small arteries occurs, leading to subsequent ischemia and cutaneous infarction. Herein, we report the case of a diabetic patient with end-stage kidney disease on dialysis, presenting multiple intensely painful necrotic plaques on the lower extremities. The suspicion of calciphylaxis was raised based on the patient's medical history and clinical presentation, subsequently confirmed by radiological examination, which revealed calcifications along vascular pathways. Diagnosis can be established based on clinical and paraclinical grounds alone, and some clinicians may forego skin biopsy and initiate treatment presumptively. The management of calciphylaxis remains a challenge and requires a multidisciplinary approach since most patients experience intense pain that is often unresponsive to conventional analgesics, leading to a reduced quality of life.