The most commonly reported sites of PTLD include the gastrointestinal tract, lungs, central nervous system, and allografted organ.3 Skin involvement in PTLD is rare. On review of the literature, we found only 19 cases of PTLD presenting with cutaneous involvement.4- 6,13- 18 Only 1 patient was reported to have extracutaneous involvement at the time of diagnosis; however, staging studies were not performed in all patients (including, at the minimum, CT of the chest, abdomen, and pelvis). Gross morphology of these reported skin lesions include ulcers, nodules, and erythematous plaques. Anatomic sites included the face, trunk, and extremities. Consistent with previously reported lesions, our patients exhibited nodules and erythematous plaques on the face, trunk, and extremities. Seventeen of the previously reported cases had B-cell lesions, whereas 2 had T-cell lesions. Of the cases that underwent testing for EBV (15 of the 17 B-cell cases), all findings were positive for EBV. In our study, all lesions expressed B-cell markers, and most of the lesions analyzed were positive for EBV. Fourteen of the 17 previously reported B-cell PTLD cases went into remission after the reduction of immunosuppressive therapy with or without other adjuvants such as surgical excision, radiation therapy, and/or antiviral therapy. Three patients had progressive disease despite treatment efforts. All patients in our study had a favorable response to therapy. Although most previously reported cases show PTLD development within the first 5 years after transplantation, disease did not develop in 3 of our 4 patients until 8 or more years after transplantation.