LAUSR

tion disorders of the retina (age-related macular degeneration), skin (peripheral arterial disease) and ear (sudden hearing loss) (2). Its concept is based on the Fåhraeus-Lindqvist effect (3). Double filtration rheopheresis eliminates LDL particles and high molecular weight proteins (α2macroglobulin, IgM), decreases plasma viscosity and thereby improves hemorheology and microcirculation (4). Ischemia during calciphylaxis is due to two mechanisms: (i) the reduction in the diameter of luminal vessels by phospho-calcic deposits and micro thrombi, and (ii) raised inflammatory proteins which increase blood viscosity. In our case report rheopheresis was proposed not as a treatment for calciphylaxis etiologies itself (phospho-calcic deposits), but for its microvascular impact. The first clinical benefit for our patient was reduction of pain, suggesting optimum oxygenation of tissue as early as the third treatment. The second benefit was initiation of the cutaneous scarring process, which was not achieved with previous treatments. In conclusion, we think that rheopheresis could be used as an adjuvant treatment for severe calciphylaxis to further cutaneous scarring and limit infection-associated disease.