A 77-year-old female patient who developed an ulcerative squamous cell carcinoma in the dorsal aspect of her right great toe is described. Diagnosis of the condition was delayed because of a resemblance to a variety of benign ulcerations. We stress the importance of histological examination in the face of an ulcerative cutaneous condition unresponsive to standard treatment. [Skin Cancer (Japan) 2002; 17: 193-196]