A 67-year-old Ethiopian woman presented with a large black plaque surrounded by several smaller violaceous papules on her frontal hairline for 6 months (Figure). The largest plaque was tender and occasionally itchy. She had not tried any treatments. On physical exam, the left upper forehead near the hairline demonstrated a 2-cm, smooth, pigmented plaque with a depressed atrophic center and granulomatous rim. Surrounding this plaque were several smaller smooth, pigmented, round to annular papules. 

What Is The Diagnosis?

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