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An unusual protracted course of calciphylaxis without cutaneous ulcerations has been encountered in 14 cases. Calciphylaxis may include several clinical presentations ranging from an acute, rapidly fatal course to an indolent, more benign variant. Calciphylaxis should be included in the differential diagnosis for patients with kidney disease presenting with a clinical picture of panniculitis. Patients with renal disease with a characteristic clinical presentation with or without cutaneous ulcerations should undergo an urgent biopsy to confirm the diagnosis.

Calciphylaxis is a serious and often lethal condition that mostly affects patients with renal disease. Patients with calciphylaxis typically have variable degrees of cutaneous necrosis on initial presentation. An unusual, protracted course of calciphylaxis without cutaneous ulcerations has been encountered in the case of a 46-year-old woman. Thirteen additional cases with similar presentation will be discussed in part II of this article. Calciphylaxis may include several clinical presentations, ranging from an acute, rapidly fatal course to an indolent, more benign variant.