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Mycosis fungoides is the most common form of cutaneous T-cell lymphoma (CTCL); it rarely exhibits a predilection for hair follicle infiltration. We describe a patient with preferential localization of skin lesions in the head and neck region with eyelid involvement, grouped follicular papules and acneiform lesions, severe pruritus and secondary bacterial infections. The histological presentation showed folliculotropic neoplastic lymphoid cells instead of epidermotropic infiltrates. The final diagnosis was folliculotropic mycosis fungoides (FMF), a rare, more aggressive variant of CTCL. Clinical manifestations of FMF may be challenging; thus, multiple, deep biopsy containing adnexal structures, are required to make this crucial diagnosis.