FREDERIC B.ASKINMDWILLIAM H.WESTRAMD
A 76-YEAR-OLD white man discovered a lesion on his forehead in September 2001. He complained of symptoms related mainly to local bleeding and rapid growth of the lesion. Clinical examination revealed a bruiselike macule, measuring 15 × 10 cm, with an irregular, ulcerated, bleeding plaque. The lesion involved the entire forehead, and there were several purple-red satellite nodules covered by a gray-black crust. There was no lymphadenopathy in the neck, and a metastatic workup revealed no abnormalities.
Nodit L, Hunt JL. Pathology Quiz Case. Arch Otolaryngol Head Neck Surg. 2003;129(5):591. doi:10.1001/archotol.129.5.591