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December 2007

Solitary Cutaneous Nodule in an Immunocompromised Patient—Quiz Case

Author Affiliations
 

MICHAEL E.MINGMD, MSCECARRIE ANN R.CUSACKMDSENAIT W.DYSONMDJACQUELINE M.JUNKINS-HOPKINSMDVINCENTLIUMDKARLA S.ROSENMANMD

Arch Dermatol. 2007;143(12):1583-1588. doi:10.1001/archderm.143.12.1583-a

A 47-year-old woman who had undergone renal transplantation presented with a 3-month history of a persistent ulcerating nodule on the left ankle. She had no history of travel abroad and was systemically well. Her medications included lansoprazole, doxazosin mesylate, oral tacrolimus, oral prednisolone, and atorvastatin calcium trihydrate.

Physical examination revealed a single cutaneous nodule measuring 1.0 × 2.8 cm overlying the left medial malleolus (Figure 1). The patient had no lymphadenopathy and no hepatosplenomegaly. Findings from a complete blood cell count, urea and electrolyte levels, liver function screening test, erythrocyte sedimentation rate, and chest radiograph were within reference range. A wedge biopsy sample was obtained from the lesion and sent for histologic analysis (Figure 2 and Figure 3) and culture.

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