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We present a case of 47\u2010year\u2010old man with a history of B\u2010lymphoblastic leukemia (B\u2010ALL) who presented with fever, leukocytosis, and papulonodular skin lesions, involving the extremities and trunk. A punch biopsy specimen demonstrated papillary dermal edema with a neutrophilic and histiocytic infiltrate extending into the subcutis. The infiltrate also harbored scattered large cells that were positive for CD30 and demonstrated the immunohistochemical profile of monocytes. A diagnosis of histiocytoid Sweet syndrome with CD30+ cells was made. The case is unique, demonstrating a combination of Sweet syndrome variants with subcutis involvement, histiocytoid morphology, and large CD30+ cells. A prior history of B\u2010ALL and immunohistochemical profile of monocytes with immature morphology broadened the differential diagnosis and added to the diagnostic challenge.<\/jats:p>","DOI":"10.1111\/cup.14535","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T02:54:08Z","timestamp":1695956048000},"page":"1036-1041","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neoplastic or inflammatory? 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