{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:04:38Z","timestamp":1779681878566,"version":"3.53.1"},"reference-count":11,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Calciphylaxis is a rare syndrome of microvascular calcification and skin infarction, occurring most commonly in patients with kidney failure. Calciphylaxis carries a poor prognosis, and current treatment involves mitigating risk factors, wound care, and medical therapies such as intravenous sodium thiosulfate for calcium chelation. We present an innovative treatment approach of topical sodium thiosulfate soaked gauze successfully used to treat calciphylaxis of a 58\u2010year\u2010old female with renal transplant. She presented with a tender bruise over the posterior right calf, in the context of good graft function (serum creatinine 88\u2009\u03bcmol\/L), warfarin use for metallic mitral valve, and total parathyroidectomy. Ultrasound imaging highlighted extensive subcutaneous tissue calcification. A punch biopsy of the lesion confirmed calciphylaxis and revealed acute deep ulceration within necrotic debris and calcium deposits along dermal blood vessels. She was managed with cessation of calcitriol and warfarin (switch to enoxaparin with anti\u2010factor Xa level monitoring), replacement of vitamin K2, analgesia, and diligent wound care and debridement. She had twice\u2010weekly intravenous sodium thiosulfate without any improvement and was suspended at 16\u2009weeks after developing central line bacteraemia. On routine deep tissue debridement, small hard calcium deposits resembling calcinosis were noted to superficialise. The decision was made to commence thrice\u2010weekly applications of topical sodium thiosulfate, prepared as gauze soaked in sodium thiosulfate 25% 15\u2009mL applied for approximately 15\u2009min. The ulcer completely healed, pain resolved, and topical treatment was suspended after a total of 20\u2009weeks. This case demonstrates successful treatment of calciphylaxis using topical gauze soaked in sodium thiosulfate without concurrent intravenous sodium thiosulfate.<\/jats:p>","DOI":"10.1111\/nep.70214","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T05:35:53Z","timestamp":1778304953000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Topical Sodium Thiosulfate for the Treatment of Calciphylaxis: Case Report"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2665-3945","authenticated-orcid":false,"given":"Thiveya","family":"Theivendran","sequence":"first","affiliation":[{"name":"Department of Renal Medicine Blacktown Hospital  Sydney New South Wales Australia"},{"name":"Department of Renal Medicine Westmead Hospital  Sydney New South Wales Australia"},{"name":"School of Medicine, Western Sydney University  Sydney New South Wales Australia"},{"name":"Faculty of Health and Medicine University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirna","family":"Vucak\u2010Dzumhur","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Blacktown Hospital  Sydney New South Wales Australia"},{"name":"Department of Renal Medicine Westmead Hospital  Sydney New South Wales Australia"},{"name":"School of Medicine, Western Sydney University  Sydney New South Wales Australia"},{"name":"School of Medicine, University of Notre Dame  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent W.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Westmead Hospital  Sydney New South Wales Australia"},{"name":"Westmead Applied Research Centre, the University of Sydney  Sydney New South Wales Australia"},{"name":"Centre for Kidney Research, School of Public Health, the University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3564-9892","authenticated-orcid":false,"given":"Jennifer","family":"Kim","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medicine University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Tissue Pathology &amp; Diagnostic Oncology Institute of Clinical Pathology and Medical Research, Westmead Hospital, NSW Health Pathology  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Chau","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Blacktown Hospital  Sydney New South Wales Australia"},{"name":"School of Medicine, Western Sydney University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1505292"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndtplus\/sfn008"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ced.13782"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016\u20101087"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2013.4565"},{"key":"e_1_2_10_7_1","volume-title":"Safety Data Sheet, Sodium Thiosulfate, Pentahydrate","author":"Chem Supply Australia","year":"2024"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12738"},{"issue":"9","key":"e_1_2_10_9_1","first-page":"1042","article-title":"A Novel Treatment for Ulcerative Calcinosis Cutis","volume":"10","author":"Bair B.","year":"2011","journal-title":"Journal of Drugs in Dermatology"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882\u2010017\u20100556\u2010z"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm1501013"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2025.2611464"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70214","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.70214","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70214","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T03:29:45Z","timestamp":1779679785000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.70214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/nep.70214"],"URL":"https:\/\/doi.org\/10.1111\/nep.70214","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2026-03-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70214"}}