All Norweigian heart transplant recipients with more than one year's survival (n = 140) were investigated for dermatological disorders. Observation time after transplantation was 1-10 years (mean 5.0 years). Patients alive at the end of 1993 (n = 122) were examined clinically, and medical records for all patients were reviewed. The histopathological diagnoses of excised skin specimens were reevaluated. Malignant skin tumours (i.e. basal cell carcinoma, squamous cell carcinoma and malignant melanoma) and/or premalignant skin tumours (i.e. morbus Bowen (carcinoma in situ), solar keratosis and keratoacanthoma) were found in 34 patients (24.3%), of which 18 patients (12.9%) had malignant skin tumours. Seventeen lesions diagnosed as keratoacanthoma and two lesions diagnosed as morbus Bowen had primarily been diagnosed as squamous cell carcinoma. Five patients (3.6%) had multiple keratoacanthomas. Other frequent dermatological diagnoses included hypertrichosis (86.9%), steroid-induced skin features (59.8%), common warts (42.6%) and seborrheic skin disorders (20.5%). This study demonstrates the importance of dermatological surveillance in the follow-up of heart transplant recipients.