Keratoacanthomas are squamous cell neoplasms known to be abundant in epidermal growth factor receptors (EGFRs). Erlotinib (Tarceva(®); Roche) is a low molecular weight oral quinazoline compound that binds to the intracellular EGFR tyrosine kinase domain and inhibits receptor phosphorylation and downstream signalling. We report a case of refractory, locally aggressive keratoacathoma centrifugum marginatum of the scalp having strong EGFR expression and demonstrating excellent response to erlotinib.