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Actinic keratosis

A pre-malignant lesion on the sun-exposed scalp that feels like a rough, dry, adherent, sandpaper-like patch.

Angiosarcoma

An aggressive vascular malignancy, often on the scalp of the elderly, that presents as an ill-defined, expanding, bruise-like patch or purpuric nodule.

Aplasia cutis

A congenital condition presenting at birth as a localized absence of skin, most commonly a solitary, hairless, membranous or ulcerative lesion on the scalp vertex.

Atypical fibroxanthoma

A low-grade sarcoma on the sun-damaged scalp of the elderly, typically presenting as a rapidly growing, solitary, reddish, ulcerated nodule.

Basal cell carcinoma

Presents as a pearly, translucent papule or nodule with fine, overlying blood vessels (telangiectasias) and a tendency to centrally ulcerate.

Cylindroma

A benign adnexal tumor presenting as a solitary or multiple smooth, pink nodules, which when multiple can coalesce to form a 'turban tumor'.

Dermoid cyst

A congenital cyst, often found in the midline of the scalp, that is firm, non-tender, and may be fixed to the underlying periosteum.

Epidermoid cyst

A firm, dome-shaped subcutaneous nodule containing keratin, which is less common on the scalp than a pilar cyst and may have a punctum.

Kerion

A severe, inflammatory fungal infection of the scalp (tinea capitis) presenting as a single, boggy, pustular, and exudative mass with hair loss.

Lentigo maligna

A form of melanoma in situ on sun-damaged skin, appearing as a slowly enlarging, irregularly pigmented brown-to-black macule.

Lipoma

A benign tumor of fat, presenting as a soft, mobile, non-tender subcutaneous nodule.

Melanoma

A malignant tumor of melanocytes, often appearing as a new or changing pigmented lesion that may be hidden by hair.

Nevus sebaceous

A congenital hamartoma of sebaceous glands, usually on the scalp, presenting as a hairless, yellowish, waxy, and slightly raised plaque.

Pilar cyst

A very common, firm, smooth, mobile subcutaneous nodule on the scalp that lacks a central punctum and contains homogenous keratin.

Pilomatrixoma

A benign hair follicle tumor presenting as a very hard, deep-seated, rock-like nodule that may have a bluish hue.

Seborrhoiec keratosis

A benign, waxy, hyperpigmented, 'stuck-on' papule or plaque with a verrucous surface.

Spitz naevus

A benign melanocytic nevus, common in children, that often appears as a rapidly growing, symmetric, pink or red, dome-shaped papule or nodule.

Squamous cell carcinoma

A malignant tumor presenting as a firm, indurated, hyperkeratotic, or ulcerated nodule on the sun-exposed scalp.

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