The clinical aspect of the lesions suggested the following diOE erential Sir, diagnosis: pyoderma gangrenosum, leukaemic skin in ltration or skin Di OE erent skin manifestations have been described in patients metastasis from an internal tumour.with leukaemia (1-4). These are classi ed into two main types:Histologic examination of a perineal nodule showed epidermic those caused by tumour cell localization in the skin and those ulceration with dense dermal in ltration of tumour cells between collagen bands and adjacent structures (Fig. 2 ). Blood extravasion
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