A 70-year-old woman presented with a round, fleshy, well-demarcated lesion on her left cheek that measured 1 cm in diameter (Figure 1). She had noticed a gradual increase in the size of the lesion over the past 6 months but denied any symptoms. Her medical history was notable for diabetes and hypertension; she had also undergone a kidney transplantation 10 years earlier. She was on a maintenance regimen of immunosuppressive therapy with cyclosporine (4 mg/kg per day) and prednisolone (5 mg/d); she was also taking gliclazide (80 mg/d) and nifedipine (30 mg/d). She had no personal or family history of skin cancer. The findings of her physical examination were otherwise normal. A skin biopsy was performed (Figure 2 and Figure 3).
Machado S, Costa V, Canelhas Á, Massa A. Nodular Lesion in a Kidney Transplant Recipient—Quiz Case. Arch Dermatol. 2003;139(9):1209-1214. doi:10.1001/archderm.139.9.1209-a