We report on a 40-year-old male, Jamaican patient who presented to us in January 2023 with pruritic, pinheadsized, disseminated papules over the entire integument after intensive medical treatment for hypercalcemia (serum calcium 4.8 mmol/l) (Figure 1). Computed tomography showed multiple osteolyses, as well as cervical, thoracic, and abdominal lymph nodes of accentuated size. Bone marrow aspiration revealed a clonal T-cell population that was also detectable in the skin biopsy. Dermatohistological analysis revealed circumscribed wedge-shaped infiltrates of pleomorphic lymphoid cells predominantly with F I G U R E 1 (a) Image of the back with flat, slightly scaling, dark brown papules. (b) Detailed image of the upper leg.