Case Report: Lobomycosis Successfully Treated with Posaconazole

Lobomycosis (lacaziosis) is a chronic subcutaneous disease caused by the fungus Lacazia loboi, which is reported mainly in Central and South America, mostly from Brazil and Colombia.(1,2) Peru has reported only two cases to date.(3,4) Lobomycosis is characterized by subcutaneous nodules with keloid-like, ulcerated, or verrucomatous surfaces. Lacazia loboi has never been isolated in culture from humans. Therefore, the diagnosis is based on identifying yeast-like cells by direct examination of exudates or skin scrapings, or by histopathologic analysis. There is no standard treatment for this disease. A wide surgical excision for small and well-demarcated early lesions may be effective, but relapses are common. We report a third case of lobomycosis in a patient from Peru and the first patient treated with posaconazole.