Lesson of the month 1: A rash decision

Cellulitis is a common condition and several mimics exist which should be considered in patients who fail to respond to antibiotics. We describe the case of a patient with anaplastic large cell lymphoma masquerading as a lower leg cellulitis. The patient had failed to respond to intravenous antibiotics and a skin biopsy confirmed her diagnosis. She received radical radiotherapy to the lower leg but later developed shortness of breath and was identified to have pulmonary infiltration of the lymphoma. She died shortly afterwards from lobar pneumonia. This case highlights the importance of regularly reassessing patients with suspected cellulitis and considering alternative diagnoses in cases that fail to respond to treatment.