A 47-year-old black woman presented with a 4-year history of an enlarging plaque on her chin. She described the primary lesion as a small, skin-colored papule that gradually increased in size. It was occasionally associated with mild pruritus, but was otherwise asymptomatic. The patient had not sought treatment for the lesion before presentation. However, the plaque's slow but progressive growth was of cosmetic concern. The patient was otherwise healthy. She was not experiencing any constitutional symptoms. She denied other significant medical problems, and there were no other family members with similar disease. Physical examination demonstrated a 1-cm, firm, annular, skin-colored plaque on the right side of her chin (Figure 1). A punch biopsy specimen was obtained (Figure 2 and Figure 3).