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Case 173: Scalp Lesion

This lady says that she hit her head and the wound failed to heal. When asked how long ago that injury was her family think it may have been 6 months ago. They say that they have noticed a lesion there that has slowly grown bigger with time.

A close up

1. If you took a small punch biopsy of the edge of this lesion what do you think it may show?

2. The lesion feels to be fixed to the underlying pericranium. Now what are the options?