An 85-year-old female with a medical history notable for hypertension, type 2 diabetes, and end-stage renal disease necessitating regular hemodialysis every Tuesday, Thursday, and Saturday, presented with the acute onset of a purple discoloration localized to the right side of her tongue in a Wednesday morning. Upon presentation, the patient had a body temperature of 97.5°F (36.4°C), pulse of 81 beats/min, respiratory rate of 18 breaths per minute, and blood pressure of 113/56 mm Hg. There were