Purpureocillium lilacinum is a rare pathogenic fungus that is mainly reported in patients with solid organ or bone marrow transplants, and those on corticosteroid therapy. Our case reports a 57-year-old man who presented to our dermatology clinic with 6 months of tender hand and lower leg nodules initially biopsied as well-differentiated squamous cell carcinomas (SCC) on a background of a renal transplant. Repeat biopsy and tissue culture confirmed Purpureocillium lilacinum skin infection which demonstrated rapid improvement on oral posaconazole. We highlight a key issue of questioning the diagnosis of SCC as the clinical picture was not suggestive, despite the individual lesions fitting the initial histopathological diagnosis. We suggest that a thorough history including hobbies, and full skin examination would aid in the diagnosis of this treatable fungal infection to avoid unnecessary surgery and morbidity.