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A 70-year-old woman presented with an asymptomatic pigmented lesion located on the right shoulder that had first been noticed about 1 year prior. She reported no previous trauma. On examination, there was a depressed, smooth, firm, white and bluish plaque that measured about 15 mm in diameter (Figure 1). The dimple sign was present; it was not painful. Immediately after clinical palpation, the plaque started to grow in size and became painful (Figure 2). On dermoscopy, a blue-violaceous homogeneous area was observed in the center of the lesion surrounded by a whitish homogeneous area (Figure 3). A delicate pigment network was found at the periphery of the lesion, over the whitish area, and scattered dotted and linear vessels were also present. The lesion was completely excised. Histopathologic examination revealed a very cellular dermal neoplasm composed of interlacing spindle cells with vesicular nuclei and eosinophilic cytoplasm within collagen bundles arranged in a storiform pattern. Blood-filled spaces that lacked an endothelial lining, multifocal hemorrhage and hemosiderin deposition were intermixed with the collagen bundles. (Figure 4). Spindle cells were positive for factor XIIIa and negative for CD34, actin, desmin, S-100, melan-A and HMB45. A diagnosis of aneurysmal dermatofibroma was established. A white-bluish plaque with rapid growth after palpation