A 73-year-old woman presented with a lesion on her back that she had had for at least 50 years. The lesion had been stable for decades, but recently, over a period of a few months, it had gotten larger and changed color. There was no history of trauma to the lesion. The patient was otherwise in excellent health. Physical examination demonstrated a 1.5-cm, lobulated, cystic nodule, varying in color from pink to blue (Figure 1). A biopsy specimen was obtained (Figure 2 and Figure 3).