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A patient was referred for removal of a persistent ‘benign’ lower lid lesion. She previously had two shave excision biopsies for ‘papilloma’ of the right lower lid by the nurse practitioner. Her recurring symptoms included redness, and crusting at the lid margin. An excision biopsy showed an incompletely excised desmoplastic tricholemmoma (DT-figure 1A–D; see legend). A year later, a rapidly expanding, recurrent lesion was seen at the same site. An excision revealed an unexpected nodular basaloid tumour (figure 1E–G).