A man in his early 50s presented with a petechial maculopapular eruption with rapid dissemination to the entire body including the face and ears. Peripheral lymphadenopathy was noted. He also had an elevated white blood cell count of 26 900/μL. (To convert white blood cell count to ×109/L, multiply by 0.001.) He had mild pruritus with no other constitutional symptoms. Skin biopsies showed a prominent perivascular and periadnexal infiltrate of small to medium-sized monomorphic lymphocytes with focal erythrocyte extravasation but without evidence of vasculopathy or vasculitis. Immunohistochemical analysis revealed a CD20+, CD5+, cyclin-D1+, CD3‑, CD10‑, and CD23‑, infiltrate, consistent with cutaneous involvement by MCL (Figure). Staining for skin-homing molecules revealed a cutaneous lymphocyte-associated antigen (CLA)‑, L-selectin (CD62L)+ infiltrate.