A 62-year-old white man presented with suspected cholesterol emboli. A discrete 2.5-cm pink, firm nodule was incidentally noted on the vertex of his scalp (Figure 1). Blue-gray pigmentation was noted at the inferior portion of the nodule. The lesion, which was asymptomatic, was present for more than 20 years. A punch biopsy specimen was obtained (Figure 2, Figure 3, and Figure 4).