A 76-year-old man with a history of basal cell carcinoma presented for evaluation of a lesion on his left cheek. He had noticed the lesion approximately 6 months earlier and reported that the lesion had been increasing in size. His medical, surgical, social, and family histories were otherwise unremarkable. Examination of the lesion revealed a blanching, telangiectatic macule, measuring approximately 12 mm, with ill-defined margins (Figure 1). The lesion persisted despite laser treatment and was therefore excised and sent for histologic examination (Figure 2 and Figure 3).