Follicular malignant melanoma (FMM) is an exceptionally rare variant of melanoma arising on sun-damaged skin of elderly patients. It is characterized by a prominent involvement of hair follicles with atypical melanocytes extending deep along the follicular epithelium, permeating parts of the follicle as well as the adjacent dermis. The clinical diagnosis of follicular malignant melanoma may easily missed because the tumor often resembles a comedo or a pigmented cyst. The authors report a case of a follicular melanoma arising from a 71-year-old female’s nostril, reviewing the literature to illustrate the clinical picture, histopathological features and recommended management of this rare disease.