We report a patient with late onset mucocutaneous pigmentation characteristic of Peutz-Jeghers syndrome, who also developed hyperpigmented macules within preexisting psoriatic plaques. This has rarely been reported. Macular pigmentation of the forehead and dorsum of the fingers was also a prominent feature. It is important to consider other causes of mucocutaneous pigmentation including Addison’s disease, the Laugier-Hunziker syndrome, chemotherapeutic agents and HIV diseas