Clinical Challenge: A New Scalp Lesion in a Man With a History of Cancer

An 84-year-old man presents with a lesion on his scalp, which he first noted several months earlier. The growth is painless but has recently begun to bleed spontaneously. He gives a history of ample lifetime sun exposure as well as basal and squamous cell carcinomas and solar keratoses. Examination reveals a 1.8-cm erythematous nodule. Cervical and submandibular lymph nodes are ...