A pigmented macule in the nose: what’s your diagnosis? The differential diagnosis of pigmented macules of the facial skin can be challenging. Dermoscopy may help, and adding confocal microscopy improves specificity and sensitivity; histopathology, however, remains the gold regular prescription drugs side effects . Case presentation A man in his 60s presented for a full skin check. He previously heavily sun-damaged pores and skin and a past background of lentigo maligna on the nose that was treated three years ago with cryotherapy and imiquimod.