Firm lesion on the lateral thigh

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Figure 1
A hyperpigmented nodule on the lateral thigh.
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Figure 2
Retraction with lateral compression.

TABLE 1

Differential diagnosis of a firm, hyperpigmented, macular skin lesion

Condition	Characteristics
Lentigo maligna	Irregular asymmetric pigmented macules that grow centrifugally
Dermatofibrosarcoma protuberans	Similar to dermatofibroma, but larger, irregular border, deeper skin invasion
Seborrheic keratosis	Shiny (“oily”), well-demarcated macule or papule, “stuck-on” appearance
Epidermoid inclusion cyst	Flat or raised flesh-colored cystic lesion; often has dark central punctum; size varies; may spontaneously drain
Dermatofibroma	Slow-growing, firm, tan to reddish-brown papules, < 1 cm, that “dimple” to lateral compression