A 51-year-old black man presented with nonpainful subcutaneous nodules that had appeared insidiously on his torso, arms, and face over the previous 2 months (Figure 1). He had been undergoing workup for a 5-kg weight loss, cramping abdominal pain, and frequent, loose, nonbloody stools, when lesions in the liver suggestive of metastases were noted on a computed tomographic scan. He had been scheduled for a liver biopsy before dermatologic presentation. His medical history was significant for hypertension, which was controlled with nifedipine therapy, and alcohol abuse. Wheezing, flushing, and other cardiovascular symptoms were absent.