October 2011




History:  74 year old White Male with no previous history of skin cancer presents with sores on his scalp.  He began noticing the sores a few weeks ago  after hitting his head while getting out of his car.  He denies any weight loss, shortness of breath, lymph node swelling, night sweats, or abdominal pain


Past Medical History:  Hypertension, unspecified heart arrhythmia.

Medications:  Atenolol, amlodipine, lipitor, aspirin, vitamin B12.

Allergies:  No known drug allergies.

Physical exam: Ulcerated heme crusted plaques in confluence at posterior scalp with satellite 1-2cm subcutaneous bluish nodule at R parietal scalp (Fig. 1).  No cervical, axillary, groin, or post-auricular lymphadenopathy.

Laboratory/imaging:  Whole body PET scan demonstrated FDG-avid soft tissue thickening of the right high parietal scalp without evidence of metastatic disease.



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