Buprenorphine for the Management of Intractable Pain in Skin Ulcers Associated With Calcific Uremic Arteriolopathy.

Abstract

Background: Calcific uremic arteriolopathy, or calciphylaxis, is a rare and severe condition marked by calcification of small-to-medium blood vessels, causing tissue ischemia and necrosis. The pain is excruciating, emanating from tender lesions, severely impacting movement and touch. No approved treatment exists, making effective pain management vital for improving quality of life and outcomes.

Case report: A woman with end-stage renal failure and calciphylaxis-related ulcers on the inferior pannus, left medial thigh, and right gluteus experienced refractory pain despite opioid therapy. Palliative care initiated adjustive buprenorphine, yielding remarkable and sustained pain relief.

Conclusions: This case emphasizes the urgent need for better treatment options for calciphylaxis, particularly in pain management. The success of adjunctive buprenorphine highlights the debilitating condition, ensuring comprehensive pain management.