A 64-year-old Hispanic man was seen with a 2-month history of an asymptomatic tumor on his right cheek (Figure 1). Physical examination revealed a 6 × 4-cm red-brown, well-demarcated, indurated plaque on the right cheek and multiple red-pink indurated plaques on his back. Clinically enlarged lymph nodes were not found. The patient had no history of new or altered medications. Laboratory tests revealed a hemoglobin level of 15.1 g/dL; hematocrit, 44.8%; and white blood cell count, 4.0 × 103/μL, with 48.3% lymphocytes. (To convert hemoglobin to grams per liter, multiply by 10.0; to convert white blood cells to 109/L, multiply by 0.001.) Four-millimeter punch biopsy specimens were taken from the patient's right cheek and left upper back (Figure 2 and Figure 3).