Clinical Quiz
The Hong Kong Practitioner VOLUME 26 / March 2004

An immuno-suppressant patient presenting with a rapidly progressive rash
K K Lo 盧乾剛

A monthly clinical quiz is published in The Hong Kong Practitioner. Readers are invited to participate and a prize draw, sponsored by Pfizer Corporation Hong Kong Limited, will be undertaken among the successful entries each month. For entry into the draw, simply answer the question, fill in the reply slip and return it to the College by April 6, 2004. Each reader is allowed to submit one entry only. The name of the winner and the answer will be published in the April issue.
Clinical history:

This is a 40 years old patient with end-stage chronic renal failure secondary to diabetic nephropathy. He had a successful renal transplant operation three months prior to the skin eruption. He was put on immuno-suppressant therapy and systemic steroid for control of graft rejection. Increasing number of slightly itchy papules and nodules were noted on the right cheek of this patient for the previous two weeks. They were progressive and extended towards the centre of face and nose.

The slide and the question were prepared by:
Dr K K Lo, FRCP, FHKCP, FHKAM(Med)
Consultant Dermatologist-in-Charge,
Social Hygiene Service, Department of Health.

What is your diagnosis?

A. Trichophytic granuloma
B. Steroid induced rosacea like eruption
C. Kaposi sarcomas
D. Granuloma annulare

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