A 65-year-old Chinese female presented with a long standing growth over her back that had been enlarging in size for the past 10 years, with contact bleeding noted over the past 1 year. The lesion had been present since childhood. There were no systemic complaints. On examination, a 3 x 3 cm, sessile, firm, pigmented, slightly ulcerated lump was noted over her mid back (Fig. 1). There were no palpable inguinal or axillary lymph nodes.
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