Derm Dx: A hairdresser notices a scalp lesion on her client

An 89-year-old woman presents with a scalp lesion for which her hairdresser suggested she seek evaluation. The patient was unaware of its presence, stating that the site neither itches nor bleeds. She is fair-skinned and admits to ample past sun exposure. She denies prior history of skin cancer but was treated in the past for "pre-skin cancers." Examination reveals a ...