A Warty, Fungating Lesion

July 15, 2016

This lesion on the posterior neck of a young woman was present since birth and recurred after electrodessication. Can you Dx?

This image of the posterior neck of a 26-year-old woman shows a warty type fungating  lesion about the size of a quarter. It had been present since birth. It had been excised and treated with electrodessication several times previously but had always recurred. She had acute and chronic anxiety and would pick at the lesion.

The lesion was elliptically excised under local anesthesia in the office.

What is the most likely diagnosis?