<p>We present a case of penile ulcerations in a 42-year-old man with acute promyelocytic leukemia (APML) and leukemia cutis. After treatment with all-trans retinoic acid and arsenic trioxide, he developed localized penile ulcers resistant to antibiotics. Skin biopsy revealed infiltration of atypical cells positive for CD34, MPO, and CD10, confirming leukemia cutis. The ulcers improved following chemotherapy with daunorubicin and azacitidine. This case highlights penile ulcerations as a rare manifestation of leukemia cutis in APML, underscoring the importance of considering leukemic infiltration in differential diagnosis of genital ulcers when infectious causes are excluded.</p>