A 16-year-old girl presented with an asymptomatic solitary erythematous nodule on the back that developed over a 6-month period with no history of antecedent trauma. She denied a history of a preceding skin lesion, treatment of the lesion, ulceration, or bleeding. Physical examination revealed a nonblanchable, solitary, 1.2-cm smooth firm erythematous nodule on the upper back with no surrounding pigmentation or purpura (Figure 1). A shave biopsy specimen was obtained (Figure 2 and Figure 3).