A 24-year-old man presented with a slow-growing, asymptomatic, 20-cm sized well-circumscribed lesion on his left upper back, consisting of several small, follicle-centred, discrete to coalescing, brownish-black to bluish macules. The lesion also demonstrated multiple, soft, well-circumscribed papules and nodules, with overlying follicular pigmentation. There was no hypertrichosis or underlying musculoskeletal defect [Figure 1].

Figure 1: A well-circumscribed lesion on the back consisting of multiple brownish-black to bluish hyperpigmented macules and multiple soft well-circumscribed papules and nodules.

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Dermoscopy revealed follicle-centred brownish-black to bluish pigmentation in a reticulo-globular pattern, with intervening normal skin [Figure 2]. On histopathology, the dermis showed aggregates of uniform nevus cells surrounding the hair follicles along with abundant melanophages. Based on clinical features, dermoscopy, and histopathology, we diagnosed it as congenital follicular melanocytic naevus, also called spotted grouped pigmented naevus.

Figure 2: Dermoscopy showing follicle-centred brownish-black to bluish pigmentation with a reticulo-globular pattern and intervening normal skin (DermLite DL3N; contact, polarised, 10x).

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