This case is a unique report of cutaneous metastasis from a perivascular epithelioid cell tumor (PEComa). It should alert dermatologists to consider PEComas in the differential diagnosis of benign and malignant neoplasms presenting in cutaneous or subcutaneous sites. Given their uniform expression of melanocytic markers, it is not surprising that PEComa may be confused with melanoma and clear cell sarcoma of soft tissue.