Cutaneous T-cell lymphoma with porokeratosis-like lesions

We describe two black patients who had widespread, sharply demarcated, round, hyperpigmented or hypopigmented macules that clinically resembled disseminated superficial actinic porokeratosis (DSAP). One patient was known to have cutaneous T-cell lymphoma (CTCL), and the other patient had only the DSAP-like lesions. Histopathologic and immunohistochemical studies of the DSAP-like lesions revealed characteristic features of patch-phase CTCL. This unusual variant of patch-phase CTCL should be differentiated from DSAP and the hypopigmented variant of CTCL.