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The Merkel cell carcinoma is a rare and highly aggressive neuroendocrine skin tumor. The purpose of this paper is to warn of the possibility of this diagnosis, usually not considered as an initial hypothesis in cutaneous neoplasias. The authors describe two cases of elderly female patients with complaints of a single erythematous nodule on the face. The diagnoses of basal cell carcinoma and amelanotic melanoma were considered. The presence of telangiectasias was evident at dermoscopy. The incisional biopsy’s histology evidenced Merkel cell carcinomas. This neoplasia typically occurs in Caucasian patients with over 65 years of age, emerging as an erythematous-purplish nodule of rapid growth, with immunohistochemistry being essential for the diagnosis.

Merkel cell carcinoma: clinical, dermoscopic and immunohistochemical aspects of a rare tumor