A 25-year-old white man was referred to the dermatology clinic for evaluation of an asymptomatic, slowly enlarging plaque located on the posterior aspect of his left shoulder. The plaque was first noticed approximately 8 years ago and had been examined by several physicians, who felt the lesion was not of concern; thus, no treatment was rendered.On examination, a 2.5\m=x\1.5-cmfirm, violaceous, slightly depressed lesion was noted superior to the left scapula. Adjacent to this firm area was an atrophic-appearing area of the lesion that was less pigmented and more depressed (Fig 1).A 3-mm punch biopsy specimen was taken from the lesion and is shown in Figs 2 and 3.