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Solitary Cutaneous Nodule in an Immunocompromised Patient—Quiz Case
Minal N. Singh, MRCP;
Susan Andrew, MRCPath;
David Fitzgerald, MRCP
Hope Hospital, National Health Services Trust, Manchester, England (Drs Singh and Fitzgerald), and Ysbyty Gwynedd, Bangor, Wales (Dr Andrew)
Arch Dermatol. 2007;143(12):1583-1588.
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REPORT OF A CASE
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 x 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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What is your diagnosis?
SECTION EDITOR: MICHAEL E. MING, MD, MSCE; ASSISTANT SECTION EDITORS: CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; JACQUELINE M. JUNKINS-HOPKINS, MD; VINCENT LIU, MD; KARLA S. ROSENMAN, MD
RELATED ARTICLE
Solitary Cutaneous Nodule in an Immunocompromised Patient—Diagnosis
Arch Dermatol. 2007;143(12):1583-1588.
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