Calciphylaxis: a rare limb and life threatening cause of ischaemic skin necrosis and ulceration

Calciphylaxis (uraemic gangrene syndrome) is a rare complication of chronic renal failure and secondary hyperparathyroidism. Patients present with pai nful purple skin lesions which undergo necrosis and ulceration. The histolo gy is specific. There is medial calcification with intimal hyperplasia and thrombosis of the lumen of small sized arteries in the underlying: subcutan eous tissue. Death frequently arises from overwhelming sepsis. Early recogn ition of this condition and prompt parathyroidectomy can lead to rapid reli ef of symptoms and ulcer healing and may be life saving. (C) 2000 The Briti sh Association of Plastic Surgeons.