A 4-year-old boy was referred to the outpatient dermatology clinic for two growths on his scalp. The first lesion had been present on the vertex scalp for six months and was asymptomatic except for recent inflammation and drainage of white exudate. A second growth developed on the patient's posterior parietal scalp in recent weeks and reportedly resembled the original appearance of the initial lesion. Review of systems was negative, and the parents denied any affected close contacts. There had been no intervention to the lesions. On examination, the vertex of the scalp revealed a 0.3 cm hemorrhagic crusted papule with surrounding desquamation and minimal surrounding erythema. The left posterior parietal scalp had a 0.2 cm