Cutaneous T-cell lymphoma with porokeratosis-like lesions

We describe two black patients who had widespread, sharply demarcated, round, hyperpig-mented 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 immunohis-tochemical 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.