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Facial lesion that came “out of nowhere”

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A 33-year-old woman had a facial lesion (Figures 1 and 2) that seemed to “come out of nowhere,” but it was months before she sought medical attention. She was certain that the duration was months, not years, but could not date the exact onset.

The lesion was asymptomatic except for its prominence and aesthetics. The patient had tried cutting the lesion off several times, but it regrew each time. She was married, mono-gamous by history, not pregnant, had no major underlying medical conditions, and had no personal or family history of skin malignancy. The remainder of the skin examination was normal.

FIGURE 1
Facial lesion with sudden onset

This lesion on the patient’s cheek appeared over a period of months.

FIGURE 2
Detail of the lesion

Except for its prominence on the patient’s face, the lesion is asymptomatic.

What is your diagnosis?
What would be your management plan?

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