Penile calciphylaxis with extragenital gangrene

Penile calciphylaxis is a rare cause of penile gangrene and is typically associated with multiple comorbidities, most commonly diabetes mellitus and hyperparathyroidism. It demonstrates a high mortality rate of 64% and is seen almost exclusively in patients with end-stage renal disease on hemodialysis. Underreporting of this disease likely occurs, contributing to a paucity of data and lack of formal therapeutic guidelines and approved treatments. Conflicting guidance exists regarding effective treatment strategies, with most formal literature existing in the form of case reports. Herein, we describe a 44-year-old man with end-stage renal disease on hemodialysis who presented with a 2-month history of nonhealing wounds on his penis and lower extremities.