Spiky Skin in a Renal Transplant Recipient

A woman in her 70s with a cadaveric renal transplant presented with a 1-year history of a facial cutaneous eruption and mildly pruritic lesions, initially affecting malar cheeks and eyebrows and subsequently spreading to involve the nose, chin, upper trunk, and extremities. What is your diagnosis?
Source: JAMA Dermatology - Category: Dermatology Source Type: research