Sweat gland adenocarcinoma is a relatively uncommon malignancy. Clinical features are painless red or violet papules and nodules that can occasionally become ulcerated. The biological behavior is aggressive and metastatic sweat gland carcinoma spreads through the lymphatic. The treatment of choice is wide surgical excision with regional lymph node dissection. The portrayed ase was a 60-year-old female who presented with an ulcerative plaque on the scalp. Skin biopsy, radiologic examination, and immunohistochemistry (IHC) assay revealed adenocarcinoma of the sweat gland. Reconstructive surgery was performed immediately after Mohs surgery to repair the damaged site.