Dermatological conditions are common in general practice and can present diagnostic challenges. Acral fibrokeratoma is a rare, benign, slow-growing tumour, usually hyperkeratotic, affecting extremities such as fingers, toes, or nails. Although uncommon, it should be considered in differential diagnoses of acral lesions. Diagnosis is histological and treatment requires complete excision. (1)A 61-year-old previously healthy woman presented to primary care with a painful lesion on the plantar region of her right foot. The pain worsened with weight-bearing, progressively limiting her daily walks. The lesion had been present for approximately 15 years, gradually increasing in size over time, with no history of trauma or other associated dermatological conditions. On physical examination, a pedunculated, skin-colored lesion with a hyperkeratotic tip and broad base was observed on the anterior third of the plantar foot, measuring 15 mm in length and 5 mm in diameter. Complete excision was performed, and histopathological analysis confirmed acral fibrokeratoma.Plantar acral fibrokeratoma is rarely described, with most reports involving periungual or digital lesions. This case is notable for its long duration, atypical plantar location, functional impairment, and detection in primary care, followed by timely referral for definitive management.Systematic skin examination is essential. Primary care clinicians should consider rare fibrous tumours in the differential diagnosis of hyperkeratotic acral lesions. Educating patients on skin changes may reduce delays in seeking care.Although uncommon, acral fibrokeratoma has distinctive clinical features that can guide suspicion. Histological confirmation remains essential. Complete excision provides definitive treatment with minimal recurrence.Recognition of acral fibrokeratoma in primary care enables timely referral, diagnosis, and treatment. Early identification prevents prolonged discomfort and improves patient quality of life. Keywords: acral fibrokeratoma; primary healthcare; dermatology   References: 1. Malik S, Erickson CP, Calame A, Cohen PR. Acquired giant plantar fibrokeratoma: case report and review. Dermatol Online J. 2021;27(5):1–5.