Early-stage cutaneous lymphoma often mimics non -malignant skin disorders, leading to common misdiagnoses and delays in appropriate treatment. A 44 -year-old Malay male presented with a progressive ulcerating nodular lesion on his left medial forearm, which had been treated for a pyogenic cutaneous infection with three different courses of oral antibiotics. The patient even attempted selftreatment with traditionally prepared chalk powder. On the fourth visit to the primary care clinic, a referral to the dermatology clinic was made. A biopsy was done, and histopathology and immunohistochemistry studies of the skin lesion were suggestive of anaplastic lymphoma kinase (ALK) negative anaplastic large cell lymphoma (ALCL). Staging of the disease showed that it was limited to an early stage without systemic involvement. The cutaneous lymphoma in this case was successfully treated with radiotherapy after the failure of oral methotrexate. Early recognition of pc -ALCL is important to avoid delayed treatment. This case highlights the need for greater awareness among primary care physicians of unusual but important dermatological disorders, particularly cutaneous malignancies. Misdiagnosis can impair the patient -doctor relationship and reduce patient compliance with treatment.

Intramuscular haemangioma is relatively rare and accounts for less than 1% of all haemangioma. Most of these tumours occur in the trunk, arms and legs. Only 14% of all intramuscular haemangioma arise from the head and neck region, with masseter muscle representing the most common site of involvement, followed by the trapezius and sternocleidomastoid muscles. We present a case of a 60-year-old man with a soft lump in the left cheek. Imaging of the neck showed irregular, dilated enhancing vessels seen in the left masseter muscle suggestive of intramuscular haemangioma. Excisional biopsy was performed, and histopathological findings confirmed the diagnosis.