A 40-year-old white woman presented with a 2-week history of fever, myalgia, diffuse arthritis, and nausea and vomiting, and a 1-week history of tender, warm nodules on her lower extremities. She had undergone orthotopic cardiac transplantation 4 months earlier and had experienced multiple episodes of rejection, which required immunosuppressive therapy. Physical examination revealed approximately twenty 5- to 10-cm erythematous, warm, tender nodules on her lower extremities (Figure 1 and Figure 2) She was febrile (temperature, 39.5°C) and had arthralgias and myalgias. The findings of the rest of the physical examination were normal; in particular, there was no palpable lymphadenopathy or hepatosplenomegaly.
Baggett K, Grande K, Hsu S. Tender Nodules on the Legs of a Cardiac Transplant Recipient. Arch Dermatol. 2000;136(6):791-796. doi: