It is a rare condition characterised by the infiltration of skin by leukemic cells before their appearance in the peripheral blood or bone marrow. We report a case of aleukemic leukemia cutis in a fit gentleman, who rapidly progressed to acute myeloid leukomia. However, the outcome was fatal within 3 months of diagnosis of skin lesions. Case Report: An 82 year old retired policeman was referred to dermatology department with several weeks' history of a symptomatic generalised erythematous

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... -nodular rash on face, upper limbs, trunk, and lower limbs following a flu jab. He had a past medical history of asthma and hypertension and he was on ibesartan and salbutamol inhaler. There was no improvement following oral and topical steroid and also changing his antihypertensive medication Ibesartan to doxazocin by his GP. On examination he looked very well with no lymphadenopathy or organomegally. The rash (Fig 1a, 1b, 1c, 1d) was reddish-purple infiltrative, firm, papulo-nodular lesions about 0.5 to 1.5 cm in diameter with a smooth surface on the torso and proximal parts of the extremities. All blood tests including full blood counts,