A 70-year-old white woman presented to the dermatology clinic with a “mole” that had been growing on her right cheek for the past five years. The lesion was a darkly pigmented plaque with a verrucous appearance. There was definite color variation within the lesion, which measured 4.0 × 3.8 cm. In addition to this facial mass, the patient had numerous prominent skin tags in her axillae and groin. Although the lesion on her face was asymptomatic and did not bother the woman, her two daughters complained that it looked terrible. The woman’s family physician told her the lesion was probably harmless, but her daughters were pressuring her to have it removed. Except for a history of mild hypertension, the patient was in good health.

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