Calcific uremic ateriorolopathy (calciphylaxis)
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In patients with ESRD
angular, very tender ecchymotic areas
later, areas slough
Biopsy is gold standard but biopsy site doesn't heal
very high mortality
can try soft tissue X-ray or CT, bone scan, mammogram of 
extremity
correct Ca x PO4 product
can use non-calcium phosphate binder, decrease PTH, stop 
Coumadin? inhibits matrix GLA protein which might inhibit bone 
formation. IV pamidronate, sodium thiosulfate are experimental  
but may be effective.