Merkel cell carcinoma with squamous and sarcomatous differentiation.

Merkel cell carcinoma is an aggressive neuroendocrine tumor historically thought to arise from neural crest-derived cutaneous neuroendocrine cells. Recent evidence supports an epidermal origin. We present a case of Merkel cell carcinoma arising on the upper arm of a 94-year-old woman that had multiple morphologic patterns: small cells typical of Merkel cell carcinoma, malignant cells with squamous differentiation and malignant poorly differentiated spindle cells.

Bilateral facial apocrine chromhidrosis.

A young woman presented to the office with a history of bluish discoloration involving the superior malar region bilaterally. When the bluish discoloration became darker, she would press on her cheeks resulting in excretion of "black sweat" that temporarily lightened her skin color. Examination revealed ill-defined slightly swollen soft plaques involving both superior cheeks.