A Man with an Umbilicated Papule of the Hand: What Is Your Diagnosis?

    A 61-year-old sheep farmer presented with a painful nonpruritic on the left hand that lesion had been present for approximately 5 weeks. He neither had previous history of similar lesions nor did he have a history of cancer or other dermatologic conditions. Physical examination demonstrated a 1cm pearly, umbilicated papule with raised borders (Figure 1).