This is a 12×6 mm soft, pink nodule with a small area of ulceration in the right axilla of a man in his late 60s with a history of basal cell carcinomas (fig 1). The lesion was asymptomatic and had remained stable over several years. The clinical diagnosis of this ulcerated, single, flesh coloured nodule was uncertain as these combined features are not typical of benign lesions and the nodule lacked the usual rough, warty, and fissured appearance of a seborrhoeic wart, or the usual pigmented colour of a melanocytic naevus. An excision biopsy was performed and showed histological features of a fibroepithelioma of Pinkus. These rare variants of basal cell carcinomas were first described in 19531 and present as slow growing pink or flesh coloured warty papules or plaques. They are often diagnosed retrospectively, and management involves surgical excision with 4 mm margins.2bmj;383/nov09_10/e075419/F1F1f1Fig 1
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