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June 2013

Exophytic Nodule on the Scalp—Quiz Case

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD; LORI D. PROK, MD

JAMA Dermatol. 2013;149(6):751-756. doi:10.1001/jamadermatol.2013.3314c

A healthy 9-year-old boy presented with a painless, rapidly growing lesion on his scalp that had been present for a year. His primary care physician attempted excision early in its growth, which was unsuccessful with early local recurrence. On physical examination, no other similar lesions or café au lait spots were detected on his body. The lesion was a 1.9 × 1.5-cm pink, multilobulated, soft, exophytic nodule on the right occipital scalp with alopecia overlying the nodule (Figure 1). He had a number of ephelides on his face, neck, and shoulders but no true lentigines. His mouth was clear of any pigmented lesions. The lesion was surgically excised in the subgaleal plane with advancement flap closure and was reviewed for histological diagnosis (Figures 2 and Figure 3).

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