We describe 9 patients with a novel variant of lymphomatoid papulosis characterized by prominent localization of the infiltrate around the eccrine coil, resulting in nodular expansion of the coil accompanied by variable granulomatous inflammation. Light microscopy, immunohistochemical analysis using antibodies to CD2, CD3, CD4, CD5, CD7, CD8, and CD30 in 6 cases, and polymerase chain reaction–singlestranded conformational polymorphism analysis for Tcell receptor γ chain gene rearrangement in 5 cases revealed 2 cytomorphologic patterns (large cell dominant with polymorphous inflammation, small cell lymphocyte-rich with an inconspicuous large cell component [phenotypes, CD30+/CD3+/CD4+/CD7– for large atypical cells; reactive for small lymphocytes]) and clonal restriction in 4 and polyclonality in 1 of the lymphocyte-dominant cases. During an average 6-year follow-up, no lymphomas developed. Recognition of this variant is important— accentuation of the infiltrate around the eccrine coil and cutaneous nerves, presence of granulomatous inflammation, dominance of small lymphocytes in the dermis, and variable extension into the panniculus may lead to diagnostic confusion with entities such as discoid lupus erythematosus, Jessner lymphocytic infiltrate of skin, subcutaneous T-cell lymphoma, and persistent arthropod bite reaction. Our findings suggest that pruritus, a younger age at diagnosis, and a more indolent course are defining clinical features. The prototypic lymphoproliferative disorders that express the activation marker Ki-1 (CD30) are Hodgkin disease (HD), 1 anaplastic large cell lymphoma (ALCL), 2-4 lymphomatoid papulosis (LyP), 5,6 and rare cases of large cell B- or T-cell lymphoma. The distinctive manifestation of LyP is a chronic, self-limited dermatosis comprising recurrent “crops” of ulcerative nodules and papules resolving within 3 to 6 weeks, the histologic features of which comprise an atypical lymphocytic infiltrate mimicking malignant lymphoma. Roughly 10% of LyP cases manifest the subsequent or concurrent emergence of cutaneous T-cell lymphoma, HD, or ALCL. 7-9 In some cases, molecular studies suggest an evolution of lesions of LyP into mycosis fungoides (MF) or primary cutaneous CD30+ ALCL rather than the secondary lymphoma being a genomically independent event.