A 74 year-old woman presented with cutaneous Hodgkin's disease and local bone involvement. Both were secondary to regional lymph flow obstruction by lymph nodes massively involved by nodular sclerosing Hodgkin's disease. Though a temporary remission was achieved by combination chemotherapy, skin lesions were quick to reappear in spite of continued treatment. This was felt to be due to local mechanical factors. A review of the literature reveals two main patterns of Hodgkin's disease of the skin. In one, the disease is either confined to the skin, or is unrelated to existing nodal or visceral involvement. In the other, skin infiltration is secondary to regional lymph node involvement by Hodgkin's disease, as seen in our patient. The pattern of skin involvement by Hodgkin's disease should be taken into consideration in assessing its prognostic significance.