Warfarin skin necrosis mimicking calciphylaxis in a patient with secondary hyperparathyroidism undergoing peritoneal dialysis

We report on a patient who presented with painful skin ulcers on the lower extremities after administration of warfarin following a valve operation. Calciphylaxis was considered first because of the host factors; eventually, the skin lesions were diagnosed as warfarin skin necrosis by biopsy. The skin lesions improved after warfarin discontinuation and short-term steroid therapy. Most patients with end-stage renal disease have some form of cardiovascular disease, and some require temporary or continual warfarin treatment. It is important to differentiate between warfarin skin necrosis and calciphylaxis in patients with painful skin lesions.
Source: Kidney Research and Clinical Practice - Category: Urology & Nephrology Source Type: research