A 56-year-old white woman presented with a solid erythematous nodule on her scalp that had developed 6 years earlier. She denied having a fever, losing weight, or sweating during the night. Her medical history was notable for epilepsy, which was adequately controlled with phenothiazine and chlorpromazine therapy. When a solitary nodule first appeared on the patient's head 6 years earlier, a biopsy specimen revealed nodular, dense B-cell infiltrates without blasts, nuclear atypias, or mitoses. Therefore, the lesion had been regarded clinically and histologically as a B-cell pseudolymphoma. The patient was subsequently treated with potent topical corticosteroid creams and local psoralen–UV-A, but within 2 years the preexisting nodule became larger and 2 further nodules appeared despite the therapy. After topical chemotherapy using carbomustine and topical corticosteroids, the patient had a partial response consisting of a reduction in tumor size, but the tumors recurred after a few months.