Pigmented BCC has been very well documented in patients with darker eyes and skin; however, the number of cases reported in lighter-skinned individuals, including those with type I skin, is limited.1,2,4,5 Tan et al5 in 2008 proposed that the predilection for African American, Hispanic, and Asian populations could be owing to the ability to tan along with the greater melanogenic capacity of dark-haired patients. In a study by Bart and Schnall1 in 1973, only 10% of patients with pigmented BCC had light brown eyes, while the eyes of the remaining 90% were dark brown. There were no cases reported in other eye colors. Rossiello and colleagues6 in 2006 described a case of pigmented BCC in a 29-year-old white woman. There have been few cases of pigmented BCC reported in white patients with blue eyes, further supporting an association with darker skin and eye color.7 Differentiating pigmented BCC from melanoma or atypical melanocytic nevi is essential; in our case, the diagnosis was determined by characteristic histologic findings of benign proliferation of melanocytes throughout the basaloid tumor islands and numerous pigment-laden melanophages within the fibrocellular tumor stroma. Despite the fact that only 7% of BCCs are pigmented,6 and they are uncommon in fair-skinned populations, pigmented BCC should be included in the differential diagnosis of atypical pigmented lesions in patients with lighter skin or eyes.