Leukemia cutis is a term used to describe a dermatologic manifestation of hematologic malignancies. It represents a wide range of identifiable cutaneous lesions that result from the infiltration of neoplastic leukocytes in patients with leukemia or lymphoma. We report a case involving an initial solitary lesion without systemic symptoms, but a biopsy revealed a seborrheic keratosis in the epidermis with lymphoid infiltration in the dermis. Flow cytometry studies confirmed a B-cell chronic lymphocytic leukemia, and an additional investigation with fluorescence in situ hybridization demonstrated a chromosomal deletion in the long arm of chromosome 13 at position 14, indicating a favorable prognosis. The patient was referred to a hematologist, who determined that no pharmacologic treatment was necessary at that time. The patient continues to follow up for monitoring of his disease.