A patient with leonine facies and occult lung disease.

摘要

A 70-year-old male patient presented with a 2-week history of a skin eruption involving the face, neck, axillae, groin, palms, and dorsa of the hands. He had no systemic complaints and no significant past medical or surgical history. He was a smoker (30 pack years), and had no specific occupational exposure.On examination he was found to have leonine facies (fig. 1), with coarse facial features and grey velvety plaques on pressure areas of the face. He was also noted to have velvety hyperpigmentation in the neck (fig. 2), axillae and the groin. Furthermore, the dorsa of the hands had brown thickened skin with a pebbly appearance (fig. 3) and the palms showed rugose thickening with more pronounced skin markings (fig. 4). His general and systemic clinical examination was otherwise unremarkable.