Pityriasis rotunda is an unusual disease characterized by perfectly circular or oval-shaped dyschromic patches with a scaling surface. Histologically, the lesions resemble those of ichthyosis vulgaris. They typically involve the abdomen, the trunk and extremities. The etiology of the disease remains unknown. Pityriasis rotunda has been most commonly associated with tuberculosis, nonlymphoproliferative neoplasms such as hepatocellular carcinoma and gastric carcinoma, and malnutrition. Rarely, hepatic cirrhosis, leprosy, endometriosis, and familial G6PD deficiency can be associated with pityriasis rotunda. We describe here a patient with pityriasis rotunda associated with hepatocellular carcinoma. Pityriasis rotunda can be a presenting sign of hepatocellular carcinoma in the setting of chronic liver cirrhosis.