Figure 1. Clinical and histological features.

(A) The presenting site, a large, ulcerating lesion on the scalp, is shown. The inset shows a nodular lesion on the forearm, which was the site biopsied at our institution. (B) At low power, the tumor is seen to infiltrate the full thickness of the dermis and focally extend to the subcutaneous fat (H&E, 20×). (C) At high power, the tumor cells are mostly medium-sized to occasionally large and have visible nucleoli (H&E, 1000×). (D) The tumor cells show extensive epidermotropism (H&E, 400×).