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 Best of Five 2.18

 

   

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BOF: 2.18

A 40-year-old female who has end stage renal failure and is on renal replacement therapy presents with painful skin lesions that came on suddenly and are progressing rapidly. She also gives a history of recent , sudden weight loss. On examination she has lesions on her thighs. The lesions are star shaped, purpuric lesions with central ulceration. They are indurated and extremely tender.

Biopsy of these lesions shows calcification of the media of the small and medium sized vessels with intimal hyperplasia and fibrosis. This is surrounded by a mixed inflammatory infiltrate.

In this patient which of the following forms of treatment would be of no benefit?

a)      Judicious use of antibiotics

b)      Surgical debridement

c)      Hyperbaric oxygen

d)      Parathyroidectomy

e)     Immunosuppression

 

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