Dermatopathology

A 7-year-old boy had a scalp lesion over a congenital alopecic patch. The plaque had gradually increased in size and thickness since birth. Examination showed a 3 × 2 cm orange to skin-coloured, mildly verrucous plaque on the frontal scalp. Anteriorly, there was a flesh-coloured, lanceolate-shaped, lobulated plaque and haemorrhagic crusting that was not tender or friable.