A 57-year-old African American man presented to an oral and maxillofacial surgeon for evaluation of a brown pigmented patch on the left side of the hard palate. The lesion was of unknown duration and was reported by the patient to be asymptomatic, although he did endorse occasional pruritus. An extraoral examination was performed without any abnormal findings. On intraoral soft tissue examination, a brown pigmented patch located predominantly on the hard palate was observed. The lesion had well-defined but irregular borders, measured 2 × 1.2 cm in size, and was nontender to palpation (Figure, A). Findings of the remainder of the intraoral soft tissue examination were within normal limits. An incisional biopsy was performed, and the specimen was sent for microscopic diagnosis.