Pheochromocytoma is a catecholamine-producing tumor of the sympathetic nervous system. Signs and symptoms are generally related to catecholamine excess; including hypertension, diaphoresis, headaches, palpitations and anxiety attacks. Hypertensive crisis is usually present when pheochromocytoma is suspected initially. Cutaneous manifestation of pheochromocytoma was uncommon. Pallor could be seen in association with marked vasoconstriction. However, severe vasoconstriction may cause purpuric, erythematous skin rashes and acrocyanosis over the extremities. It has also been seen to diminish peripheral pulsations, which result in non-detectable of non-invasive blood pressure (NIBP). In this ”pseudo-shock” situation, it may be treated as hypotension in shock status and adrenergic agonists are usually be administered which causes more deterioration of the disease process and fatal outcomes.