A recently available pale nodule with pseudocysts The diagnosis of pigmented lesions is a daily challenge in general practice. Dermoscopy can provide extra clues, but requires significant expertise. Case presentation Over a one-month period, an 85-year-old man noted the development of a pale pigmented nodule in a tan-coloured macule that were present for five years on his left shin. Biopsy of the nodule revealed bed sheets of atypical spindle cells with mitoses within the dermis and scant melanin pigment.People were at least 50 years of age at enrollment and did not die before age 65 years. Related StoriesBoston Children's and Rock Health team up to accelerate development of pediatric wellness technologiesHeart of the Rockies Regional Medical Center selects Aprima EHRNew UCLA study looks at primary care medical home in reducing childrens' repeat appointments to hospitalsOverall, 76 percent of individuals engaged in ACP, with 2.8 percent having an AD only, 9.3 percent a DPOA only, 13.9 percent an ACP debate only, 9.4 percent an AD and a DPOA, 5.9 percent an AD and an ACP debate, 8.8 percent a DPOA and discussion, and 26.0 percent all three elements. The mean time from completion of an Advertisement to death was 61 months, as the right time to death after DPOA completion was 56 months.