Abstract
REPORT OF A CASE An 88-year-old man was in good health until June 1984, when an asymptomatic small blue nodule developed on his left external ear. By October 1984, the mass had enlarged and ulcerated and had undergone several episodes of spontaneous bleeding; several new blue nodules had appeared in the left periauricular area. The development of left facial weakness and drooping prompted admission to The Johns Hopkins Hospital, Baltimore, where he was first seen in January 1985. There was no prior history of radiation or trauma. The rest of the patient's medical history was unremarkable. Physical examination revealed an elderly man with a left peripheral seventh nerve palsy. There were discrete and confluent, poorly demarcated, blue-to-purple nodules and plaques infiltrating the left preauricular, auricular, submandibular, and anterior cervical areas (Fig 1). Posterior to the left auricle was a 5 × 4-cm violaceous lobular mass, with central necrosis and hemorrhage
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