Here we have quite a tricky one which has bamboozled many other searchers over the years, with some pointing to the bony-faced killer in 1964's The Phantom of Soho as the true identity of the Living Skull. However the source for this grinning ghoul is actually not quite that obscure, but is very easy to overlook all the same. It is in fact a character named Dr Death who appears in the 1974 AIP flick Madhouse which starred Vincent Price and Peter Cushing. In this movie, Vincent Price plays an aging horror star, Paul Toombes, who made his name appearing in a series of movies which had the character of Dr Death as the main hero/villain. However when the franchise is to be restarted with Toombes coming out of retirement to play the role, the good Doctor seemingly steps off the silver screen to commit a series of bloody murders... Anyhow the mystery killer appears in the movie like this -

Dr Death in Madhouse (1974)

And you can hear more about this movie, alongside some other gems starring the great Vincent Price on this episode of my podcast here

Madhouse poster
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