Cutaneous melanoacanthoma is a rare benign epidermal melanocytic lesion. It occurs in the head and is similar to seborrheic keratosis or pigmented basal cell carcinoma. It grows slowly and is usually seen in elderly male patients. It rarely occurs on the back. A 55-year-old woman presented with a red-colored nodular lesion of her back. Four years previously it had been noted by the patient; it was a red colored nodular lesion and 0.5 cm in diameter at that time. It had enlarged and was now 4 cm in diameter. Previous biopsies had been diagnosed as basal cell carcinoma and it was for this reason she was seen. On physical examination, a painless, crusty, red-black-colored, mobile lesion, 4 cm in diameter, was observed. The lesion was totally excised, and repaired with a Limberg flap. The specimen was sent for histopathological examination, which revealed a diagnosis as a melanoacanthoma. No recurrence was seen 6 months later and the postoperative result was cosmetically acceptable.