A 9-year-old boy came in for an evaluation of a lesion on his right posterior shoulder that developed approximately three months prior to presentation. The lesion was not painful, but it bled with minimal contact.
No prior trauma to the area was reported, and there was no personal or family history of similar lesions. A review of systems was negative for fever, chills, malaise, and unusual weight loss.
On physical examination, the patient was noted to have a 4-cm exophytic nodule covered by dried heme crust. A shave biopsy was performed.
What’s the Diagnosis ?