Abstract
68-years-old man with end-stage-renal-disease (ESRD) and obesity presented with painful penile lesion: necrotic glans, extended till the penile base with the exposition of corpora cavernosa. Laboratory testing were normal and was afebrile so subsequently discharged with antibiotic therapy and medications. Clinical evaluation was suggestive for penile calciphylaxis, confirmed by seeing arterial calcifications at CT. Patient died one month later. Penile calciphylaxis is a rare life-threatening condition characterized by vascular calcification and fibrosis of medium and small arteries which causes an obstructive vasculopathy and tissue necrosis. Normalization of metabolic parameters, antibiotics, topical enzymatic debridement agents are recommended, considering the poor outcome.