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Tender Nodules on the Legs of a Cardiac Transplant Recipient
Kelvin Baggett, MD;
Kimberly Grande, MD;
Sylvia Hsu, MD
Baylor College of Medicine, Houston, Tex
Arch Dermatol. 2000;136:791-796.
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REPORT OF A CASE
A 40-year-old white woman presented with a 2-week history of fever, myalgia, diffuse arthritis, and nausea and vomiting, and a 1-week history of tender, warm nodules on her lower extremities. She had undergone orthotopic cardiac transplantation 4 months earlier and had experienced multiple episodes of rejection, which required immunosuppressive therapy. Physical examination revealed approximately twenty 5- to 10-cm erythematous, warm, tender nodules on her lower extremities (Figure 1 and Figure 2) She was febrile (temperature, 39.5°C) and had arthralgias and myalgias. The findings of the rest of the physical examination were normal; in particular, there was no palpable lymphadenopathy or hepatosplenomegaly.
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Figure 1.
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Figure 2.
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Laboratory tests revealed the following values: white blood cell count, 5.5 x 109/L (0.90 neutrophils, 0.06 lymphocytes, 0.03 monocytes, 0.01 basophils, and no eosinophils); hemoglobin, 85 g/L (reference range, 120-160 g/L); and hematocrit, . . . [Full Text of this Article]
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