case: A 3.5-year-old girl presented with a 1-year history of a slow growing pigmented lesion on the dorsal aspect of her right foot. Physical examination revealed the presence of a pigmented patch with color distribution from pink to tan to dark brown, relatively well circumscribed and approximately 1.5 × 2cm with irregular borders, and especially a single dark central papule superimposed in the middle of it (Figure 1). The lesion had a soft consistency and the child did not have any other symptoms. During the last year, it had increased in dimensions and thickness. The remainder of her physical examination was insignificant. Also, there was no positive family history of a particular disease or any history of trauma or drug usage. A 3 mm punch biopsy was obtained from the central dark papule and the specimen was sent for histopathologic examination.