A previously healthy 3-year-old girl presents with a 5-week history of an enlarged nodule involving the right frontal scalp area that began as a reddish-purple papule. There is no history of pain, redness, or drainage. She is afebrile and otherwise asymptomatic. However, she had experienced minor trauma 2 years ago when she accidentally struck her head on a table. Her grandmother describes her granddaughter's living conditions as "filthy," and the girl often plays outside in the soil. Household animal contacts include frequent exposures to puppies and kittens.
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