A man in his 60s presented with a subcutaneous nodule on the right side of the chest. Due to impaired mental status, he was unable to describe the precise age of the lesion, but his wife reported it had been present at least several weeks. She recently noted a new, bright red growth on top of the nodule. The lesion was asymptomatic but seemed to be growing in size. Physical examination revealed a 3-cm firm fixed nodule on the right side of the chest with an overlying, exophytic bright red papule. No similar lesions were found elsewhere on physical examination. A punch biopsy of the lesion was performed.