Cutaneous disorders can allow the detection of severe systemic disease. We report the case of a woman with vaginal ulcerations. The lesions persisted despite oral antibiotics, antifungal therapy and local care. Biopsy showed an inflammatory ulcerating process with discrete vasculitis. Peripheral blood count showed thrombocytopenia and monocytosis, and bone marrow smears revealed as subacute myelomonocytic leukemia. A review of the literature indicates that genital ulcerations are not known in association with subacute myelomonocytic leukemia. In our case, the persistent vaginal ulcerations were the initial symptom of the subacute myelomonocytic leukemia.

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