Patient presents with a solitary, well-defined, hyperkeratotic papule consistent with a clinical diagnosis of lichenoid keratosis.  The lesion, measuring approximately [measurement] cm in diameter, exhibits a violaceous to reddish-brown hue and is located on the [location, e.g., sun-exposed skin of the dorsal forearm].  The patient reports the lesion has been present for [duration] and may have initially appeared as a small, rough, or scaly spot.  Symptoms, if present, include mild pruritus or tenderness.  Differential diagnoses considered include actinic keratosis, seborrheic keratosis, squamous cell carcinoma in situ, and melanocytic nevus.  Dermoscopy reveals [dermoscopic findings, e.g.,  a central hyperkeratotic plug, Wickham striae-like features, and a surrounding erythematous halo].  No lymphadenopathy was noted.  Given the clinical presentation and dermoscopic features, a biopsy is [indicated/not indicated at this time] to confirm the diagnosis and rule out other potential pathologies.  The patient was educated on the benign nature of lichenoid keratosis, sun protection strategies, and potential treatment options including cryotherapy, topical corticosteroids, or observation.  Follow-up is recommended in [timeframe] to monitor the lesion and discuss further management if needed.  ICD-10 code L43.8 (other specified lichenoid dermatoses) is applicable.