Granulomatous skin lesions in a renal transplant patient

Excerpt

In April 2011, a 54-year-old male from Southern Italy presented with multiple asymptomatic nodular lesions involving the lower limbs. He reported some of these nodules had appeared 5 months earlier, while others, of which many had resolved, dated back in time 3–4 years. Treatment with topical antibiotics and corticosteroids repeatedly failed to cause any evident improvement of these lesions. Patient’s history revealed the presence of arterial hypertension, ulcerative colitis since 1981, and nephrotic syndrome secondary to mesangial glomerulonephritis, since 1976, which led him to hemodialysis at first and eventually to bilateral kidney transplantation in 2001. Consequently, the patient took the following medications mesalazine, methylprednisolone, azathioprine, tacrolimus, propranolol and amlodipine. …