A Cutaneous Lymphoma Mimicking Superficial Skin Abscess in a Child

6-year old boy was admitted with complaints ofredness and swelling on the skin of his abdomenthat developed after an insect bite and was refractoryto treatmentwithtopical and oral antibiotics, with history of10dayswithoutfeveranditching.Thepreviouslyhealthypa-tient’s physical and mental development was consistent withhisage;however,therewasaswollen,5 5-cmerythematouslessionontheabdominalskinthatwas10cmabovefromtheumbilicus, along with normal other system examinations(Figure 1; available at www.jpeds.com). Hemoglobin,platelets, white blood cell count, and biochemistry were allnormal, and there were 80% neutrophils with 20%lymphomonocytic cells in peripheral blood smear withoutatypical cells. Erythrocyte sedimentation rate and C-reactive protein were 12 mm/h (0-20) and 0.42 mg/dL (0-0.8), respectively. Superficial ultrasonography of the lesionwas reported as compatible with a thick-walled densecontent abscesses. The patient, who went through a failureof drainage of abscess, was hospitalized for intravenousantibiotic-therapy. The lesion was expanded gradually andbegan to necrotize from the top with intravenousampicillin-sulbactam treatment (Figure 2).On biopsy of the lesion, anaplastic large cell lymphomawas detected that had made an ulceration in the epidermisand vascular invasion thereunder with large pleomorphiccells consisting of multinucleated and prominent nucleoli(the Hallmark cells) with CD8 and CD30 positivity. The pa-tient, who did not have any tumor metastasis in the brain,abdomen, thorax, and the skeletal system, was transferredto the oncology department for treatment. Primary cuta-neous anaplastic large cell lymphoma, which is classified asaprimarycutaneous CD30-positivelymphoproliferative dis-order,