WSI23-111-Case-4

WSI23-111-Case-4

Case #4 - The patient is a 67-year-old male with past medical history significant for type II diabetes mellitus complicated by end-stage renal disease on maintenance peritoneal dialysis, presenting for initial evaluation of painful right leg lesions. Relevant laboratory results: Creatinine 10.74 mg/dL (reference interval 0.6-1.50 mg/dL), calcium 9.4 mg/dL (reference interval 8.5-10.5 mg/dL), phosphate 5.4 mg/dL (reference interval 2.6-4.5 mg/dL), PTH 230 pg/mL (reference interval 10-60 pg/mL). He has been treated in past for stasis dermatitis and cellulitis without resolution of his symptoms. On exam, there is a tender right shin lesion with brawny induration and no evident purpura; the lower medial calf shows dusky discoloration (see clinical photograph #4). A punch biopsy is performed.

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December 31, 1969 7:00:00 PM