Trichilemmal carcinoma is a cutaneous adnexal tumor originating from the outer root sheath of hair follicle, and it was first described by Headington in 1976. Clinically, it usually occurs as an asymptomatic solitary papule, nodule or mass on the face or scalp. This neoplasm is a malignant counterpart of trichilemmoma, and it has been reported in the literature as trichilemmal carcinoma, tricholemmal carcinoma, malignant trichilemmoma, and tricholemmocarcinoma. Although histologically, trichilemmal carcinoma frequently has maliganant features, it has a relatively benign clinical behavior. We think Mohs micrographic surgery is a useful treatment modality in trichilemmal carcinoma because the final skin defect is smaller than a wide excision. We report a case of primary trichilemmal carcinoma which had developed on the face, treated with Mohs micrographic surgery. The lesion enlarged slowly with bleeding tendency on the surface (Fig. 1). He had a past history of liver cirrhosis with elevated liver enzymes and serologic markers of hepatitis B virus infection. Abdomen computerized tomography and ultrasonograghy showed hepatosplenomegaly without any evidence of regional lymph node metastasis. We could not find any abnormal findings on the head and neck computerized tomography either.An incisional biopsy was done under the impression of squamous cell carcinoma. Histopathologically, we could observe a relatively well-circumscribed tumor, which was connected with the