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Pilomatrixoma is a benign adnexal tumour characterised by pathological hair matrix differentiation and is most commonly observed in children. It typically presents as a slow-growing, pink to purplish dermal nodule. Due to its low clinical diagnostic accuracy, pilomatrixoma is often misidentified as other tumours. This case highlights an atypical presentation of pilomatrixoma in a girl in early adolescence and underlines the importance of considering ultrasonography or proceeding directly to surgical excision for definitive diagnosis.