An 82-year-old woman presented with a 3-month history of an asymptomatic growth on the left posterior shoulder. She denied trauma, tenderness, bleeding, or pruritus associated with the lesion. The patient had a history of a nodular basal cell carcinoma on the nasal tip and had undergone cutaneous micrographic surgery in 2001 and excision of a keratoacanthoma on the left wrist in 2004.
The physical examination revealed an 8 × 6-mm smooth, skin-colored, dome-shaped papule on the left posterior shoulder (Figure 1). A shave biopsy was performed (Figure 2 and Figure 3).