A 51-year-old man presented with a growth on his umbilicus that had been slowly enlarging over the past 12 years. The lesion was pruritic and occasionally exuded a malodorous, bloody discharge. The patient reported periodic use of over-the-counter wart treatments on the growth, without improvement, but he denied any other trauma to the area.
His medical history was significant for hypertension and gastroesophageal reflux disease. His medications included hydrochlorothiazide, ramipril, ranitidine, and atenolol. He denied a personal or family history of skin cancer or other dermatologic conditions.
Dixon JE, Malone JC. A Slowly Enlarging Umbilical Nodule—Quiz Case. Arch Dermatol. 2005;141(6):779-784. doi:10.1001/archderm.141.6.779-d