An immunosuppressed man in his 60s was admitted to our hospital for hypertensive urgency. He had a past medical history significant for metastatic renal cell carcinoma, a lung transplant secondary to chronic obstructive pulmonary disease, end-stage kidney disease being treated with hemodialysis, and multiple nonmelanoma skin cancers. A dermatologist was consulted during his admission to evaluate a friable, growing lesion on his right elbow that had appeared 2 months prior. Physical exam revealed 2 closely adjacent dome-shaped erythematous nodules with edematous borders (Figure, A). A 4-mm punch biopsy was performed.
Friedman BJ, Mehta D, Chaffins ML. Friable Nodules on the Elbow of a Transplant Patient. JAMA Dermatol. 2016;152(5):567-568. doi:10.1001/jamadermatol.2015.5730