Conclusions

This case of trichilemmal keratosis contributes to the limited dermatologic literature describing this uncommon follicular keratinizing lesion and highlights its clinical relevance. Trichilemmal keratosis may present with features that overlap with a wide range of benign, premalignant, and malignant lesions. Therefore, although careful clinical assessment is essential, histopathologic examination remains the diagnostic gold standard for establishing the correct diagnosis and preventing misclassification. Awareness of this entity may help clinicians include trichilemmal keratosis in the differential diagnosis of hyperkeratotic cutaneous lesions and avoid unnecessary concern for malignancy.