LAUSR

A 42-year-old woman presented with a plaque on the medial aspect of her thigh lasting for one month. She reported bloody and purulent discharge, fevers, and debilitating local pain. She had a history of renal transplant for chronic idiopathic glomerulonephritis, for which she received prednisone, mycophenolate mofetil, and tacrolimus, and also a history of antiphospholipid antibody syndrome, for which she received warfarin treatment. Examination revealed a 7-cm ulcerated violaceous nodule (Fig 1). An incisional biopsy was obtained for diagnostic clarification (Figs 2 and 3). Tissue culture grew 31 Escherichia coli, 31 Pseudomonas aeruginosa, and 11 Bacteroides fragilis.