Trichodysplasia spinulosa (TS) is a rare skin condition seen in immunosuppressed patients that is characterized by folliculocentric papules with central spiny spicules mainly on the face. We report the case of an 82-year-old woman with a history of treated non-Hodgkin lymphoma and a recent diagnosis of stage IV colon cancer. She presented with clinical and histopathologic findings consistent with TS occurring prior to starting immunosuppressive therapy for colon cancer. We conclude that this case of TS may either be secondary to the prior immunosuppressive treatment for the non-Hodgkin lymphoma or that it may represent a paraneoplastic condition warranting appropriate cancer screenings in affected patients.