A 63-year-old white woman presented with a 10-year history of a 2-cm, ill-defined, reddish brown, smooth, nontender, slightly indurated plaque over the left cheek. She complained of monthly waxing and waning swelling of the lesion but denied pain, itching, or rapid growth. She denied a history of skin cancer, recurrent sunburns, or excessive sun exposure and confirmed diligent sunscreen use. She also denied a history of medication allergies and autoimmune diseases and was a 1-pack-per-day smoker. Her medical and family histories were otherwise noncontributory.