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JAMA Dermatology Clinicopathological Challenge
February 17, 2021

Multiple, Tender Perianal Ulcers in a Young Woman

Author Affiliations
  • 1Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
  • 2Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
JAMA Dermatol. 2021;157(4):458-459. doi:10.1001/jamadermatol.2020.5764

A woman in her late 30s was evaluated by the dermatology inpatient consult service for a 4-day history of perianal pain. Her medical history included systemic lupus erythematosus, antiphospholipid antibody syndrome, and external hemorrhoids. Six months before admission, she underwent a deceased donor kidney transplant. One month before presentation, she was hospitalized for acute cellular transplant rejection managed with systemic corticosteroids, belatacept, mycophenolate mofetil, and tacrolimus therapies. Her immunosuppressive regimen at the time of dermatologic evaluation consisted of prednisone, 5 mg daily, and mycophenolate mofetil, 500 mg twice daily.

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