A 77-year-old female presents with a history of multiple BCCs. On examination, she is noted to have a raised, undulated scalp centrally to the vertex, with mild to moderate hair loss centrally (pictured).

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<p>A 77-year-old female presents with a history of multiple BCCs. On examination, she is noted to have a raised, undulated scalp centrally to the vertex, with mild to moderate hair loss centrally (pictured). </p><p>She describes experiencing a slight itch on her scalp over the past year. Mild facial hirsutism is also noted.</p>

Professor Dedee Murrell is head of the department of dermatology, St George Hospital, Sydney; professor at the faculty of medicine, UNSW Sydney; and honorary professorial fellow at The George Institute for Global Health, Sydney, NSW.