A 60-year-old patient presented with a mycetoma of the scalp with mult
iple chronic sinuses due to nocardiosis of the scalp. Recurrent bleedi
ng from the sinuses necessitated surgical excision which led to a grat
ifying result. The case illustrates the importance of fungal culture i
n the diagnosis of cutaneous lesions and emphasises the role of surger
y in mycetoma that are resistant to conventional therapy.