Image IQ: When is a biopsy required?

A 74-year-old African American male presents with several dark brown skin colored, firm, raised lesions extending across his chest to his axilla and extending below his breast. They first appeared 30 years ago after he was severely burned in an accident. The lesions are occasionally itchy, but not painful. Recently, he experienced chest tightness with difficulty breathing deeply. He has no history of cancer or heart disease.

What is the diagnosis?

A. Dermatofibrosarcoma protuberans (DFSP)
B. Dermatofibroma
C. Keloid
D. Hypertrophic scar

ANSWER: C) Keloid

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