Thanks to Dr. Viktoryia Kazlouskaya, University of Pittsburgh, Pittsburgh, Pennsylvania, USA, for contributing this case and discussion and to Dr. Jonathan Ho, University of the West Indies, Mona, Jamaica for reviewing the discussion.
A man in his 50s presented with leonine (resembling a lion) facies and keratotic papules all over his body. He mentioned that the condition has been present since he was a child and that his mother and siblings had similar skin features. A skin biopsy was obtained.
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