The Case | A nonhealing skin ulcer in a patient 5 years after successful transplantation

Abstract

A 68-year-old man, who had received a kidney transplant 5 years earlier, presented with an extremely painful deep left-thigh ulceration. Four weeks earlier, he had experienced minor traumatic injury, resulting in a hematoma that subsequently ulcerated (Figure 1). At presentation, the ulcer was partially covered with a blackish eschar with multiple livid patchy discolorations. Furthermore, both thighs showed a purplish reticular discoloration. The patient’s posttransplant course had been favorable with excellent transplant function (creatinine of 0.75 mg/dl, estimated glomerular filtration rate >90 ml/min).