Abnormal puncta was noted on annual eye exam. Patient had not noticed it nor had her prior eye care provider mentioned it to her. Upon evaluation by oculoplastics, photos and six month recall was recommended, but the patient preferred incisional biopsy to rule out malignancy. The pathologist noted some club-like elongation of the rete ridges with pigmentation in the basal layers of the epidermis. Final diagnosis was intradermal nevus, combined type with mild atypia and patient was advised to have occasional follow up with photos.
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