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Atypical Mycobacterial Infection Complicating a Rare and Difficult to Treat Vasculopathy

Riddhish T. Sheth

Livedoid vasculopathy (LV) is a chronic, recurrent, painful, and debilitating inflammatory skin disease that causes erythematous plaques and papules primarily on a patient’s lower extremities (LE). The primary form of treatment is anti-coagulation and immunosuppression. In the presented case, our patient began experiencing LV symptoms soon after she self-treated a knee abscess secondary to a canine hair embedded in her skin. She was placed on a powerful immunosuppressive regimen that worked wonders for her disease symptoms but left her vulnerable to opportunistic infections, such as, the non-tuberculoid Runyon group 4, M. abscessus/chelonae complex. Should we as clinicians, place our patients in this kind of danger by means of treatment? We want to do what is best for our patients, but sometimes end up hurting our patients more than they were before they came to us.