A 78-year-old white man presented with a 2-year history of an asymptomatic, slowly enlarging nodule located on the scalp. The patient, who was otherwise in good health, noted increasing weight loss and fatigue during the previous year. His family history was noncontributory.
Physical examination revealed a violaceous, indurated, firm, well-circumscribed, ulcerated nodule that was 5 cm in greatest diameter (Figure 1). A punch biopsy was performed (Figure 2).
Soda R, Vidolin AP, Bianchi L, Chimenti S. A 2-Year History of an Asymptomatic Scalp Nodule—Quiz Case. Arch Dermatol. 2003;139(11):1497-1502. doi:10.1001/archderm.139.11.1497-a