A spot on the back with spokes, no joke!

Case presentation

An elderly woman with a history of skin cancer presented for a routine skin check, and a suspicious pigmented lesion was noted on her upper back. She was completely unaware of its existence, and her husband, who had failing vision, had not noticed it. As far as the patient was aware, the lesion had never bled. The remainder of her skin examination was unremarkable, with fewer than 100 bland naevi scattered mainly on the trunk and lower limbs.