WSI23-111-Case-16

WSI23-111-Case-16

Case #16 - The patient is a 55-year-old male with past medical history significant for antiphospholipid antibody syndrome (APLS) with multiple pulmonary emboli and deep vein thromboses now on coumadin, type I diabetes mellitus complicated by end-stage renal disease requiring Monday-Wednesday-Friday hemodialysis. He has had a chronic lower extremity ulcer for the past 4 years in the setting of pressure related trauma secondary to wheelchair dependence. Relevant laboratory results: Creatinine 6.72 mg/dL (reference interval 0.6-1.50 mg/dL), calcium 9.3 mg/dL (reference interval 8.5-10.5 mg/dL), phosphate 2.9 mg/dL (reference interval 2.6-4.5 mg/dL), PTH 81 pg/mL (reference interval 10-60 pg/mL). On exam, he has a chronic non-healing lesion with no evidence of retiform purpura, no induration and without exquisite tenderness (see clinical photograph #16). A punch biopsy is obtained from the edge of the lesion.

16

December 31, 1969 7:00:00 PM