{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:17:55Z","timestamp":1790983075231,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":228,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["Case Reports in Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a rare, life\u2010threatening syndrome characterized by microvascular calcification and cutaneous necrosis, predominantly affecting patients with end\u2010stage renal disease (ESRD) on maintenance dialysis, particularly those exposed to vitamin K antagonists (VKAs). We report the complex clinical course of a 35\u2010year\u2010old female patient with chronic kidney failure and triple\u2010positive antiphospholipid syndrome (APS) who presented with severe, painful bilateral thigh ulcerations. The patient had been receiving phenprocoumon for 2\u2009years. Given her high\u2010risk profile for thrombosis, managing cutaneous necrosis while maintaining necessary anticoagulation presented a profound clinical dilemma. Histopathological evaluation confirmed the diagnosis of calciphylaxis. VKA therapy was immediately discontinued and replaced with renal\u2010adjusted apixaban to manage her underlying APS as an individualized rescue strategy. A multimodal, sequential wound care regimen was initiated, incorporating serial surgical debridements, negative pressure wound therapy (NPWT), autologous platelet\u2010rich plasma (PRP) infiltration, and acellular fish skin grafting. Following intensive multidisciplinary intervention involving vascular surgery, nephrology, and dermatology, the progression of the disease was successfully halted. Significant wound contraction, stable granulation, and complete epithelialization were achieved without systemic complications. This case underscores that short\u2010term VKA exposure can act as a critical trigger for calciphylaxis in patients with multifactorial risk profiles and demonstrates that a tailored transition to novel oral anticoagulants combined with advanced wound therapies can achieve favorable outcomes in highly complex, refractory scenarios.<\/jats:p>","DOI":"10.1155\/carm\/8244011","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T07:28:33Z","timestamp":1786951713000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Vitamin K Antagonist\u2013Induced Calciphylaxis in a Dialysis Patient With Antiphospholipid Syndrome: A Multidisciplinary Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2676-3927","authenticated-orcid":false,"given":"Rafat A. 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