Trichilemmal carcinoma is a rate malignant neoplasm of hair which is derived from or differentiates towards the outer root sheath. Despite the frequent presence of histologically malignant features, it has relatively benign clinical behabior. We report a case of trichilemmal carcinoma in an 87-year-old woman who showed a solitary slightly tender, 1.5×2cm-sized, verrucous, erythematous nodule with crust on the vertex of scalp. In her past medical history, it had been excised at a private clinic without a histopathological evaluation and recurred 1 year later. Histopathologically, tumor cells showed PAS-positive cytoplasms and cytologic atypia with a few mitotic figures. The patient was treated with a wide surgical excision. She has had no evidence of recurrence or metastasis.(Korean J Dermatol 2003;41(10) : 1405~1407)