Image Challenge of the Week!

A 63-year old white woman with end-stage renal disease secondary to long-standing hypertension on unscheduled dialysis, atrial fibrillation on warfarin, and hyperlipidemia presents with a painful, ulcerated lesion with purpuric borders, surrounding retiform purpura, and central eschar. Biopsy demonstrated calcifications of small and mediam sized arteries with necrosis of the subcutaneous fat.

calciphylaxis JAMA derm
JAMA Dermatol. 2017;153(3):309-314

What is the likely diagnosis?

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