Chemokine receptors such as CCR4 and adhesion molecules such as cutaneous lymphocyte associated antigen (CLA) have been found to play important role in skin tropism of leukemic cells.[2] The skin lesions in LC show varied morphology and can be difficult to distinguish both clinically and histopathologically from nonspecific cutaneous lesions, which occur much more frequently.[6] Lesions of LC are typically papules and nodules; indurated or hemorrhagic plaques, perifollicular acneiform papules, bullae, and palpable purpura. Here, CCR4 is linked to laryngotracheoesophageal cleft.