The role of skin biopsy in calciphylaxis: Risks, benefits, and controversies

Summary: Abstract Body: The purpose of this review is to critically evaluate the role of skin biopsy in diagnosing calciphylaxis, a rare and life-threatening condition characterized by vascular calcification and progressive skin necrosis. While skin biopsy is widely regarded as the diagnostic gold standard due to its ability to provide histopathological confirmation, its use is controversial. Limitations include low sensitivity and specificity, as well as procedural risks such as ulceration and worsening of lesions. A comprehensive review of the literature highlights ongoing debates regarding the reliability of biopsy versus alternative diagnostic strategies, such as clinical evaluation and imaging techniques. Despite its limitations, biopsy remains a commonly used diagnostic tool; however, its risks may outweigh its benefits in some patient populations. This work underscores the urgent need for studies comparing patient outcomes between those undergoing biopsy and those diagnosed via alternative methods. Such research would inform clinical decision-making and encourage dermatologists to weigh the risks and benefits carefully, ultimately optimizing the care of patients with suspected calciphylaxis. Bhumik Patel¹ 1. Rowan University School of Osteopathic Medicine, Stratford, NJ, United States. Clinical Research: Epidemiology and Observational Research