It's a parasite kind of similar to anchor worms but I forgot what they're called. I would do a large water change and treat the tank with a quality anti-parasite medication. jmo
definitely think both above are reasonable guesses. Any other fish affected? Any new fish to the tank? parasites like flukes can cause lesions but if no one new etc much less likely. Definitely could be HITH. Any lesions on the fins and body? Or just the head?