A 65-year-old woman was referred for assessment of a congenital lesion on her back that had changed over the past 2 years. Examination found she had both a basal cell carcinoma and an epidermal nevus occupying the same site on her back. Dermoscopic examination revealed features characteristic of both lesions, including telangiectasias, ovoid nests, and globules for the basal cell carcinoma and milia-like cysts, crypts, and fissures for the epidermal nevus.