Objective: B-cell small lymphocytic lymphoma/chronic lymphocytic leukaemia (B-CLL) is a low-grade lymphoproliferative disorder and cutaneous lesions are rarely the presenting findings. Method: We report the case of a 62-year-old woman who presented in winter with erythematous plaque on her nose, of 3 months duration. Laboratory data showed elevated white blood cell count (40.000/mm3) with small mature lymphocytes predominance (60 %). Results: Histopathologic examination of the skin lesion reveals infiltration of the reticular dermis and subcutis, consisting mostly of small lymphoid cells, without epidermotropism. Immunohistochemical examination revealed positivity for CD20, CD79a and CD5 in the neoplastic cells. According to the laboratory and histopathologic findings the diagnosis was consistent with B-CLL with a primary cutaneous presentation. A staging bone marrow aspiration and biopsy showed 80 % infiltration by a clonal B-cell proliferation with typical CLL immunophenotyping. CT-imaging was normal, so stage I according to Binnet classification was confirmed. The patient received 6 cycles of chemotherapy and remained in remission for 1 year, when the skin lesion recurred in winter, at the same location. Conclusion: In conclusion we report an extremely rare case of subclinical B-CLL with cutaneous presentation. It is important to maintain a high index of suspicion for a lymphoproliferative process in skin lesions with atypical lymphocytic infiltration.