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Cutaneous malakoplakia presenting as a groin swelling and graft failure
  1. Ross Andrew Macdonald1,
  2. Colin Moyes2,
  3. Marc Clancy3 and
  4. Peter Douglas4
  1. 1 School of Medicine, University of Glasgow, Glasgow, UK
  2. 2 Department of Pathology, NHS Greater Glasgow and Clyde, Glasgow, UK
  3. 3 Transplant Unit, NHS Greater Glasgow and Clyde, Glasgow, UK
  4. 4 Department of Radiology, NHS Greater Glasgow and Clyde, Glasgow, UK
  1. Correspondence to Mr Ross Andrew Macdonald, 2064081M{at}


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.

  • renal transplantation
  • infectious diseases
  • pathology

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  • Contributors RAM wrote the manuscript and corresponded with the patient. CM provided the histological diagnosis, histology images, legends and text referring to biopsy and proof read the paper. MC clinically directed the management of the patient, identified the case as one of interest as a case report, supervised RAM in preparation of the manuscript and reviewed the final version. PD reviewed the imaging chronology in this case then selected and anonymised the images relevant to the clinical narrative, as well as post-processing for image fusion.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.