Early Calciphylaxis Mimicking Infection in a Patient With End-Stage Renal Disease and Sarcoidosis: A Diagnostic and Wound Management Challenge.

Calciphylaxis is a rare, life-threatening disorder primarily affecting patients with end-stage renal disease (ESRD) on dialysis. Early lesions can mimic infection, leading to delays in diagnosis and wound-directed care. We describe an atypical early presentation of calciphylaxis in a patient with ESRD and sarcoidosis, initially misdiagnosed as cellulitis. Despite early sodium thiosulfate therapy and metabolic control, the patient developed progressive necrotic wounds. This case underscores that calciphylaxis can progress despite controlled mineral metabolism and standard therapy, particularly when potentiated by conditions like sarcoidosis. Early dermatologic evaluation and a high index of suspicion are critical to avoid misdiagnosis.