Derm Dx: Large, pedunculated nodule in an obese patient

A moderately obese patient, aged 59 years, presented for evaluation of a bothersome lesion on his buttock that had been present for several years.

The patient complained that the growth occasionally rubbed on his undergarments and requested its removal. Family and personal history were negative for skin cancer.

On physical exam, a six centimeter flesh colored, pedunculated nodule was found on the ...