A 33-year-old man was referred to our clinic for evaluation of a pigmented lesion of many years' duration in the pubic area. There had been no change in the color or diameter of the lesion. Dermatologic examination revealed a papillomatous, dome-shaped, gray-black lesion with a diameter of 10 × 20 mm on the pubis (Figure 1A). On dermoscopy, exophytic papillary structures (some with jet black pigmentation) and red dots (some surrounded by a whitish halo) were observed on a lesion with a brainlike appearance overall (Figure 1B).