'Clown nose' (CN) is the common medical term referring to a reddish-brown bulge involving the tip of the nose, reminding of a clown's fake red nose. Reports about these tumours are scarce. Most reports refer to metastatic skin manifestation of systemic malignancies: this condition has been rarely described as a primary skin neoplasm. We report a case of a 31-year-old patient with a giant cutaneous squamous cell carcinoma of the nose which evolved into a CN. After ruling out genetic or immune risk factors, the patient was treated with surgical excision of the lesion and local reconstruction with good aesthetic outcome and no recurrence over a 2-year follow-up.