Leukemia cutis coexisting with dermatofibroma as the initial presentation of B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma.

: Cutaneous involvement by chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is often observed in patients with a known history of systemic disease. Rarely, CLL/SLL may initially present with skin lesions. There are also rare reports of cutaneous CLL/SLL occurring in herpes scars and as an incidental finding in excision specimens for carcinoma. We present a 76-year-old woman with an inverted conical firm papule on the upper back that was clinically suggestive of a dermatofibroma. Excisional biopsy demonstrated the presence of a dermatofibroma coexisting with CLL/SLL. We describe the rare occurrence of CLL/SLL initially presenting as leukemia cutis. In addition, to the best of our knowledge, this is the first report of dermatofibroma coexisting with CLL/SLL. This finding further expands the types of skin lesions that may coincide with CLL/SLL.