The diagnostic dilemma of leonine facies

Leonine facies is defined as displaying facial features like that of a lion with prominent convexities and furrowed creases, classically seen in lepromatous leprosy and some other rare conditions. It develops in a very small proportion of patients with cutaneous T-cell lymphoma. Folliculotropic mycosis fungoides is an uncommon subtype of mycosis fungoides that is characterised by an atypical lymphoid infiltrate of the hair follicle epithelium. It mainly involves the head and neck and is often associated with alopecia and occasionally with mucinorrhoea. We report this case for its rarity and its association with hypohidrosis to highlight its resemblance to lepromatous leprosy.