Macdonald Ross Andrew, Moyes Colin, Clancy Marc, Douglas Peter
School of Medicine, University of Glasgow, Glasgow, UK.
Department of Pathology, NHS Greater Glasgow and Clyde, Glasgow, UK.
BMJ Case Rep. 2019 Apr 23;12(4):e227460. doi: 10.1136/bcr-2018-227460.
Malakoplakia (from the Greek malakos, 'soft' and plakos 'plaque') is a granulomatous inflammatory condition, commonly presenting as a plaque in the genitourinary system, but has been shown to affect a wide variety of structures including the skin. Presentation is varied and a high degree of clinical suspicion is needed to make a diagnosis. We report a case of cutaneous malakoplakia presenting as an inguinal swelling in a 48-year-old kidney transplant patient with temporally associated graft dysfunction. New groin swelling in an immunosuppressed patient often prompts investigation centred on a malignant cause. While this is often appropriate, less common infectious and inflammatory causes should be considered. This case highlights the importance of thorough workup and investigation, including histopathology, in immunosuppressed cohorts and acts as a reminder that less common and more complex diagnoses warrant consideration in this group.
软斑病（源自希腊语malakos，意为“柔软的”，和plakos，意为“斑块”）是一种肉芽肿性炎症性疾病，通常表现为泌尿生殖系统中的斑块，但已被证明可影响包括皮肤在内的多种结构。其表现多样，需要高度的临床怀疑才能做出诊断。我们报告一例皮肤软斑病，表现为一名48岁肾移植患者的腹股沟肿胀，且伴有暂时性移植肾功能障碍。免疫抑制患者出现新的腹股沟肿胀通常会促使围绕恶性病因展开调查。虽然这通常是合适的，但也应考虑较不常见的感染性和炎症性病因。该病例强调了在免疫抑制人群中进行全面检查和调查（包括组织病理学检查）的重要性，并提醒人们在该群体中应考虑较不常见和更复杂的诊断。
