Document resource
A woman in her late 50s presented with a two month history of a scattered macular rash on her back, which progressively merged into painful purpura. She had a history of systemic lupus erythematosus treated with prednisone and hydroxychloroquine. Physical examination showed violaceous, reticular purpura with dusky central discoloration (fig 1). Laboratory test results showed thrombocytopenia (platelets 34 × 109/L; reference range: 150-450 × 109/L) but were otherwise unremarkable. Skin biopsy demonstrated circumferential vascular calcifications in small to medium vessels of the deep dermis and subcutis. A diagnosis of non-uraemic calciphylaxis (NUC) was made.