An unusual cutaneous T cell lymphoma presenting as leonine facies

We report an unusual case of a cutaneous T cell lymphoma with the clinical picture of leonine facies as the only skin symptom appearing during the fir st years of the disease. Small atypical lymphocytes with partly pleomorphic , partly indented cerebriform nuclei are present in the facial skin as well as in the peripheral blood and in the bone marrow. The lymphoma shows an i ndolent clinical behaviour without rapid progression of the disease. It sha res features with both pleomorphic small/medium-sized T cell lymphoma and m ycosis fungoides, but cannot be classified according to the criteria of the European Organization for Research and Treatment of Cancer (EORTC) Classif ication for Primary Cutaneous Lymphomas. At present the lymphoma has to be ranged among the group of so-called unspecified peripheral T cell lymphomas according to the proposal of the International Lymphoma Study Group.