Histologically, dense monomorphous infiltrates of tumor cells are located mainly in the upper and mid-dermis, separated from epidermis by a small Grenz zone (Fig. 3). Tumor cells are medium- to large-sized with round or pleomorphic nuclei (Fig. 4). Mitoses are not uncommon. Erythrocyte extravasation is a characteristic feature, explaining the bruise-like appearance (Fig. 5).

Figure 3 Diffuse dense infiltrate filling in the upper dermis and extending into the deep dermis. Note a thin Grenz zone.
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