Spiny Hyperkeratotic Projections on the Face and Extremities of a Kidney Transplant Recipient—Quiz Case

December 2006 in “ Archives of dermatology ”

Ross M. Campbell, Amy Ney, Reginald Gohh, Leslie Robinson‐Bostom

hyperkeratotic projections immunosuppression therapy tacrolimus mycophenylate mofetil punch biopsy Prograf CellCept

TLDR A kidney transplant patient developed pink skin bumps with spiny centers on her face and limbs.

A 48-year-old woman, who had undergone a kidney transplant 9 years earlier due to lupus-related nephropathy and renal failure, presented with a 6-month history of pink papules with central spiny projections on her face, arms, and legs. She was on immunosuppression therapy with tacrolimus and mycophenylate mofetil. Physical examination showed numerous 2- to 4-mm erythematous, pink papules with central spiny projections. A punch biopsy was taken from her right cheek for further analysis.

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