Abstract
Acute lymphoblastic leukemia (ALL) is a hematological neoplasm characterized by the proliferation of immature lymphoblasts. Although it is more common in children, it can also occur in adults, presenting significant clinical challenges. This case describes a 46-year-old male patient with a history of hypertension and dyslipidemia, whose first clinical manifestation of ALL was cutaneous. The patient showed resistance to initial chemotherapy, leading to complex management and, unfortunately, to a bad outcome.