Rare diagnostic challenge of an ulcerated scalp nodule in an older patient

An 87-year-old man presented with a 6-month history of an exophytic, ulcerated, single painless nodule on the scalp. He had no personal or family history of skin cancer and an unremarkable medical history. On examination, there was a 17 × 12 mm pink nodule associated with scaling and small areas of ulceration and keratosis on the vertex of the scalp.