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Enlarging lesion on the back of a 17‐year‐old boy

A 17‐year‐old boy presented to the dermatologist for evaluation and treatment of an enlarging lesion on the upper back. The lesion had been present for several years, but recently began to grow slowly. The patient denied any pain, itching, bleeding, ulceration, or other symptoms. The patient was otherwise healthy. Family history was positive for nonmelanoma skin cancer, as well as lung cancer, prostate cancer, and psoriasis. Physical examination showed a single 2.0 x 2.0 cm rubbery, indurated, immobile, violaceous tumor with visible coursing overlying telangiectasias on the upper medial right back (Figure 1). Surgical intervention was offered and performed at a later date. Histology is illustrated in Figures 2–4.