Clinical Challenge: Flesh-Colored Papule With Pigmented Speckles

A 70-year-old woman presents for evaluation of an asymptomatic growth on her right wrist, which was noted approximately 2 months ago. She provides a history of longstanding severe psoriasis now well maintained on ustekinumab. She had previously received treatment with both etanercept and efalizumab, the latter during a Phase 2 clinical trial. She denies history of skin cancer. Examination revealed ...