Abstract
A 60-year-old woman presented with two slowly-growing pink, firm, rubbery nodules on her scalp. She had a personal history of acral melanoma and of spiradenomas and trichoepitheliomas of the scalp. Her familial history was negative for skin tumors. Physical examination found numerous pink, red, and bluish smaller nodules on her scalp (Fig 1). The two larger nodules were surgically excised; histologic examination showed lobular structures in a jigsaw puzzle pattern with focal subcutaneous extension, each well circumscribed by a hyaline basement membrane.
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