Background: Darkly pigmented individuals may manifest unusual or uncharacteristic presentations of various skin conditions, including heavy pigmentation of cutaneous tumors.
Objective: To increase the awareness of an unusual presentation of Bowen's disease in a darkly pigmented individual.
Methods: We report the case of a 52 year old black woman that presented with a lesion clinically consistent with malignant melanoma. However, histopathologic examination revealed pigmented Bowen's disease.
Results: A biopsy is almost always indicated to confirm the diagnosis of lesions in darkly pigmented individuals.
Conclusion: This case is presented to reinforce the idea that pigmented Bowen's disease should be considered in the differential diagnosis of malignant melanoma.