79 yo male referred for evaluation of recently appearing rash involving legs and torso. The patient was well-appearsing and asymptomatic. Dermatologist biopsied the largest 2.5 cm red erythematous plaque. Clinical ddx included vasculitis, Sweets, hypersensitivity reaction, disseminated herpes zoster, metastasis, leukemia cutis vs atypical infectous process
Initial staging revealed PET-positive left cervical node, several mediastinal lymph nodes and right hilar node conglomerate. There was extensive uptade in the skin and bone marrow.