Cutaneous T-cell lymphomas most commonly have a CD4⁺ memory T-cell phenotype with relatively indolent course, but may in rare cases present with a CD8⁺ cytotoxic phenotype exhibiting strikingly more aggressive clinical behavior. We present two cases of the clinically aggressive subtype of primary cutaneous epidermotropic CD8⁺ cutaneous T-cell lymphoma and review the current literature, clinical behavior, and recommendations for treatment distinct from that of more common CD4⁺ variants of cutaneous T-cell lymphoma.