Subsequent review of the excisional specimen at a reference dermatopathology laboratory and at the National Institutes of Health demonstrated a nodular dermal infiltrate of small lymphocytes with a CLL/SLL immunophenotype (CD5+, CD23+, CD20+, BCL2+) and low Ki-67, leading to reclassification as cutaneous involvement by CLL/SLL. The gene discussed is MKI67; the disease is B-cell chronic lymphocytic leukemia.