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Keywords: CTCL classifications; CTCL, cutaneous T-cell lymphoma; LDH, lactate dehydrogenase; MF, mycosis fungoides; SS, Sezary syndrome; Sezary syndrome; T cell; WBC, white blood cell; clinical cases; leukemic progression; lymphoma; medical dermatology; mycosis fungoides. Conflict of interest statement Dr Dummer reports intermittent, project-focused consulting and/or advisory relationships with Novartis, Merck Sharp and Dhome, Bristol-Myers Squibb, Roche, Amgen, Takeda, Pierre Fabre, Sun Pharma, Sanofi, Catalym, Second Genome, Regeneron, and Alligator outside the submitted work. Dr Ramelyte reports intermittent, project-focused consulting and/or advisory relationships with Amgen, Novartis, Sanofi, Pierre Fabre, and Sun Pharma outside the submitted work. Dr Kim reports grants and personal fees from Actelion and 10.13039/501100009754Galderma; personal fees from Helsinn and Almirall; and grants from 10.13039/501100004628MedImmune, Kyowa Kirin, and Soligenix outside the submitted work. Drs Maredia, Cozzio, and Rozati have no conflicts of interest to declare.

Mature T-cell leukemias (MTCLs) are clonal proliferations of posttyhmic T cells that often exhibit systemic involvement including a variety of cutaneous manifestations.1 Because of the morphologic and phenotypic overlap, diagnosis of MTCLs requires comprehensive assessment of clinical presentation, immunophenotypic profiles, and serologic, cytogenetic, and molecular studies.2 T-cell prolymphocytic leukemia (T-PLL) accounts for only 2% of small lymphocytic leukemias in adults and classically manifests with striking leukocytosis, lymphadenopathy, and marked hepatosplenomegaly.1, 3 Unlike Sezary syndrome (SS), in which cutaneous presentation is a rule, only one-third of patients with T-PLL have cutaneous manifestations.4, 5, 6, 7 Cutaneous manifestations of T-PLL are heterogenous.5, 7, 8 We describe a patient who presented with erythematous patches and plaques, gyrate erythema, and bulky lymphadenopathy with an immunophenotype masquerading as SS. A diagnosis of T-PLL was confirmed using flow cytometry and cytogenetic analysis of the bone marrow aspirate demonstrating chromosome 14q32 rearrangement.