Panniculitides are inflammatory dermatoses of the subcutaneous tissue resulting from multiple etiologies, including infections, autoimmune diseases, drugs, and, less commonly, hematologic malignancies, particularly lymphoproliferative disorders. Among these, hairy cell leukemia (HCL) is a rare B-cell lymphoproliferative disorder, typically presenting with splenomegaly and cytopenias. While rare, cutaneous manifestations can occur at any stage of the disease. We report the case of a 45-year-old previously healthy man who presented with painful erythematous nodules on the lower limbs, fever (38.2°C), fatigue, and myalgias for four days. He also reported an unintentional weight loss of 5 kg over the previous four months. Physical examination revealed hepatosplenomegaly.

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