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History: This patient is a 53 year old white male previously diagnosed with chronic lymphocytic leukemia 2 years earlier. He developed an asynitomatic eruption predominantly on the hips and ears shortly after undergoing fludarabine chemotherapy. He was treated for suspected varicella zoster with high dose acyclovir without improvement. His leukemia was refractory to both CHOP and fludarabine therapy, and his cutaneous eruption continued to worsen.

Physical Examination: There were erythematous and violaceous papules with necrosis and scale on bilateral hips and helices of the ears. Confluence was present on the left hip. Abdominal examination revealed massive splenomegaly.

Laboratory Values:

CBC: WBC 26.1

Diff- Lymphs 92.8%, Monos 3.6%, Segs 3.4% Abs. Lymphs: 24.2

Hgb 9.1

Hct 28.4

Pit 35

Peripheral Blood for Flow Cytometry: 100% of CD3+ T-Lymphocytes express CD52

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