Perineurial and vascular calcification in a patient with chronic renal failure.

Sir, The term calciphylaxis, coined by Seyle in 1962 (1), traditionally describes an uncommon entity that usually presents with cutaneous necrosis due to small vessel calcification. As the original concept regarding risk factors for the disease has changed considerably in the past few years, we have recently suggested the term ‘cutaneous vascular calcification’ for this pathology, based on the study of associated diseases and clinicopathological features of 17 patients with calcification within the walls of cutaneous vessels (2). To date, however, calcium deposits in the perineurium have never been described in the setting of cutaneous vascular calcification. We report here the finding of cutaneous vascular and perineurial calcification in skin samples from a diabetic patient with chronic renal failure who developed extremely painful erythematous and violaceous lesions in the abdomen, thighs and foot.