A 60-year-old man was referred for assessment of a pigmented lesion on his cheek that had been present for 6 months. Dermoscopy of the lesion revealed a pseudo-pigmented network, slate gray dots arranging in annular-granular structures, and asymmetric pigmentation of the follicular openings and rhomboidal structures. A biopsy of the darkest area showing rhomboidal structures found lentigo maligna melanoma with a Breslow thickness of 0.5 mm.