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The authors describe a 61-year-old male patient with two previous melanoma who developed a pigmented lesion on a tattoo that was difficult to diagnose on dermoscopy but histopathology revealed the third melanoma with 0.3 mm thickness. The authors call the attention to increasing incidence of melanoma in the German population in parallel with the increase in tattooing, which may delay the diagnosis of melanoma in tattooed skin. Therefore, they recommend performing early biopsies in pigmented lesions in tattoos, especially before laser treatment of tattoos.