Calciphylaxis as a rare pathological and clinical entity generally develops in patients with renal failure, chronic dialysis and multiple factors aggravating arterial calcification and progressive peripheral ischaemic necrosis.4 Skin lesions can appear as enduring nodular painful plaques, purple in colour, necrotic scars, ulcerations or dry gangrene
.3 Intestinal, splenic, myocardial and cerebral infarcts can develop with visceral arterial calcifications.
Treatment for dry gangrene
is largely based on surgery; watchful waiting may be used to anticipate any spontaneous amputation of necrotic tissues or revascularization.
In our index case, presentation was bilateral (warmer induced injury should be unilateral), almost symmetrical, with clear line of demarcation as in dry gangrene
and amputations of digits was required.
(B) One week later, all toes on the right foot presented with dry gangrene
generally involves the tips of fingers or toes and is characterized by cool, dry, discolored lesions .
Patient also had dry gangrene
affecting few toes bilaterally.
Invariably, one or both ears showed signs of dry gangrene
. In some cases the muzzle and even the tip of the tongue became gangrenous and were shed.