A 55-year-old African American man who had undergone an allogenic kidney transplant 1 year earlier presented with symmetrical, painless, verrucous nodules on the dorsum of the lower phalanges of both feet. He reported that the lesions had first appeared as “small bumps” that had steadily grown over the next few months into firm, rubbery nodules. His medical history included refractory hypertension, hypertensive nephropathy, hemodialysis, hyperlipidemia, peripheral vascular disease, and prior kidney transplant rejection. His medications included oral tacrolimus (6 mg twice daily), oral mycophenolate mofetil (500 mg twice daily), and oral prednisone (30 mg/d).
Levy AL, Wilkin N, Poh-Fitzpatrick MB, Rasberry RD. Verrucous Nodules on the Toes of a Renal Transplant Recipient—Case. Arch Dermatol. 2007;143(5):653-658. doi:10.1001/archderm.143.5.653-a