The differential diagnosis when encountering a high-grade B-cell malignancy at a cutaneous site is broad and includes primary cutaneous follicle center lymphoma (PCFCL), primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT), high-grade B-cell lymphoma with <i>MYC</i> and <i>BCL2</i> rearrangements (HGBCL-<i>MYC/BCL2</i>), and other potential entities which must all be carefully considered before rendering a final diagnosis. Here, MYC is linked to B-cell non-Hodgkin lymphoma.