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A 21‐year‐old man with B‐cell acute lymphoblastic leukemia developed an eruption of multiple flesh‐colored nodules and persistent fevers. A lesional biopsy showed diffuse dermal infiltrates of histiocytes, foam cells, and Touton giant cells consistent with juvenile xanthogranulomatosis. Upon further investigation, the patient's constellation of findings fit criteria for Erdheim‐Chester disease.