An unusual initial manifestation of acute myeloid leukemia

Leukemia cutis is seen in around 20% of acute monocytic leukemia. They usually present as papules or nodules or infiltrated plaques but ulceration is uncommon. A 28-year-old female presented with multiple painless indurated genital ulcers of three weeks' duration with low-grade fever, gum hyperplasia, and generalized lymphadenopathy. Tissue smear from the edge of the ulcer showed atypical monocytes suggestive of leukemic infiltrate which was further confirmed by peripheral smear and bone marrow aspirate. Herein, we report a case of acute monocytic leukemia (AML) with leukemia cutis presenting initially with genital ulcers simulating chancre.