Trichilemmal Keratosis of the Lower Leg: A Case Report.

Trichilemmal keratosis is an underreported follicular keratinizing lesion that arises from the outer root sheath of the hair follicle. It is frequently confused with other common keratotic lesions. We report a 49-year-old female patient who presented with an asymptomatic nodular lesion with a prominent keratinous center on the lower dorsal aspect of the left leg. Histopathological evaluation confirmed the diagnosis of trichilemmal keratosis. This case highlights the characteristic clinical presentation of trichilemmal keratosis and its mimickers, reinforcing the importance of careful assessment of patient history, lesion morphology, and growth pattern in guiding diagnostic evaluation.